Retinal Vascular Disease
What is a Retinal Vein Occlusion?
A retinal vein occlusion occurs when the vein is obstructed from a clot or thrombosis. The thrombosis arises from compression by an adjacent artery due to plaque build-up in the artery (atherosclerosis), high blood pressure or diabetes. A Central retinal vein occlusion occurs when the vein is compressed as it travels through the optic nerve. A Branch retinal vein occlusion occurs as it crosses an arterial branch.
What is a Retinal Artery Occlusion?
A retinal artery occlusion occurs when a cholesterol or calcium plaque (embolus) obstructs the artery. The plaques usually arrive from ulcerated plaques in the carotid arteries or from cardiac valves. Other conditions include inflammatory conditions (Giant Cell arteritis), collagen-vascular disorders (Lupus), or hypercoagulable disorders (oral contraceptives, polycythymia)
What are the symptoms of Retinal Vein and Artery occlusions?
Both conditions have painless, sudden loss of vision, usually unilateral. Visual field loss can be partial in a branch occlusion or diffuse in a central occlusion. Vision in retinal vein occlusions can range from only minimal defect to significant visual loss. Vision in arterial occlusions is usually more profound and often not reversible. Even in patients with minimal visual symptoms it is important to continue follow-up with your retina doctor as complications such as macular edema, vitreous hemorrhage, and glaucoma can develop later.
How are Retinal Vein and Artery Occlusions Diagnosed?
Diagnosis is based on a thorough retinal exam often accompanied by fluorescein angiogram and optical coherence tomography imaging performed in the office.
What is the Treatment for Retinal Vein and Artery Occlusions?
Treatment of both conditions involves addressing the underlying risk factors. Because retinal vascular diseases are common in people with high blood pressure, diabetes, and other factors that cause vascular disease, such as high cholesterol and smoking it is important to follow-up with your primary doctor to assess these factors. Your retinal specialist will often request labwork and a cardiovascular evaluation. Treatment of vein occlusions may involve treating macular edema (if present) with laser or injections of medication into the eye. If new blood vessel growth (neovascularization) occurs then additional laser therapy is recommended. Unfortunately, there is no proven ocular treatment for artery occlusions at this time.
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