Clinical Diagnosis of Retinal Vein Occlusion

Abstract

occlusion (CRVO) to be between 0.1 to 0.4%. The cumulative 10-year incidence of branch retinal vein occlusion (BRVO) in the age group above 49 years has been estimated to be 1.2%. The 15-year cumulative incidences of branch retinal vein occlusion and central retinal vein occlusion were 1.8% and 0.5%, respectively, in a large population based study [2] . In the subsequent sections, we focus on the clinical presentation of these occlusions with their appearances during their natural history and alterations seen on investigations. CENTRAL RETINAL VEIN OCCLUSIONCentral retinal vein occlusion is commonly seen in older individuals, with the prevalence rising sharply over the age of 65 years. The incidence does not vary with sex. Common co-morbidities in individuals with CRVO include hypertension, diabetes, atherosclerotic disease, hematological disorders, vasculitis and autoimmune disorders (in younger individuals). Infective pathologies like HIV, syphilis, are found less frequently. Ocular co-morbidities include glaucoma, retrobulbar compression, optic nerve head drusen and crowded discs [3] . Central retinal vein occlusion (CRVO) spans a clinical spectrum from mild alteration in venous flow apparent as an impending vein occlusion to a very severe predominantly occlusive ischemic CRVO. Based on the quantum of ischemia or capillary non-perfusion in the standard ETDRS fields, the Central retinal Vein Occlusion Study (CVOS) divided this spectrum into three major categories [4] . Ischemic CRVO (ICRVO) cases had more than 10 disc areas of capillary non-perfusion on fluorescein angiography of the eye, whereas non-ischemic CRVO (NICRVO) had less than this degree of non-perfusion. Between these arbitrary categories were a group of eyes where the amount of non-perfusion could not be reliably ascertained on angiography due to blocked fluorescence from retinal hemorrhages. This category was called indeterminate type.Given that CRVO is not a static disease and may progress over time, these categories are not watertight and a large percentage (upto 80%) of indeterminate eyes turn out to be of the ICRVO type on follow up. Upto a third of patients having NICRVO at presentation convert to ICRVO patients over a three-year follow-up. Another TOPIC HIGHLIGHT Clinical Diagnosis of Retinal Vein OcclusionDaraius Shroff, Abhishek Kothari, Gagan Bhatia, Charu Gupta

Central corneal thickness, axial length, anterior chamber and optic disc structure in patients with central and branch retinal vein occlusion

“…The mean BCVA (in decimals) was 0.17 ± 0.24 in group 1, 0.33 ± 0.30 in group 2, and 0.91 ± 0. 16 The ACV was highest in control group, and the difference was significant among groups (p:0.014). While there was no significant difference between CRVO and BRVO group (p:0.998), the significant difference was between BRVO and controls (p:0.009).…”

“…All patients had at least one of the acute phase RVO findings such as intraretinal hemorrhages, dilated tortuous veins, cotton wool spots, marked narrowing of the retinal vein at the arteriovenous crossing just proximal to the hemorrhages, macular edema. 16 The diagnosis of RVO was conducted with clinical and angiographic findings and the patients were identified as BRVO (macular vein occlusion, superior or inferior temporal or nasal RVO), and CRVO (occlusion at the level of LC) according to the site of occlusion. The patients with CRVO were accepted as group 1, BRVO as group 2.…”