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Retinal venous occlusions affects/features/classifications?
- common
- >50yo
- CRVO, HRVO, BRVO
- venous occlusion-> venous stasis-> vessel damage-> ischaemia-> haemorrhage and edema
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What are the most common predisposing factors for RVOs?
old age, hypertnesion, cholesterol, diabetes, smoking, raised IOP
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Pathogenosis of CRVO?
- obstruction: thrombus in CRV, arteriosclerosis of CRA-> increases flow to CRV
- OR: compressive/inflammatory ON/orbital problems (structural abnorms in lamcrib)-> lead to CRV thrombosis
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pathogenosis of BRVO?
- compression of vein by crossing artery
- venous occlusion-> stasis-> ischaemia-> damage to retinal tissues-> hamemorrhage, edema
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Pathogenisis of HRVO?
- variant of CRVO
- occlusion of sup/inf branch of CRV
- HCRVO: involves one trunk- congenital
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What is the typical presentation of an RVO?
- uni, painless loss of VA
- asx
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medical investigations for RVO?
BP, ECG, C reactive protein, chest x ray
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ocular investigations for RVO?
- RAPD
- VF
- FA
- CV
- Gonio
- OCT
- ERG/VEP
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Why and where do haemorrhages occur in CRVO?
- NFL
- new vessels where supply is lost: leaky
- NVD/NVI ischaemic
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Is RAPD seen in ischaemic or non ischaemic?
ischaemic- related to marked retinal pathology
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Which is more common Isch or non isch CRVO?
- ischaemic CRVO: 20-30%
- non ischaemic: 80-70%
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Signs of Ischaemic CRVO?
- rapid onset venous occlusion, decreased of retinal perfusion, capillary occlusion, retinal hypoxia
- sudden severe loss of vision- macula edema
- RAPD
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prognosis of ischaemic CRVO?
- poor due to mac ischaemia
- red iris develops
- glaucoma
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TX of ischaemic CRVO?
laser to prevent NVG
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What is the fundus presentation of ischaemic CRVO?
- tortuosity and engorg of CRV branches
- extensive haem
- CWS
- Macular edema
- hyperaemia
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Presentation of NOn-ischaemic CRVO?
sudden painless mild-mod loss of VA
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Fundus presentation of non-ischaemic CRVO?
- tortous and engorgement of CRV branches
- dot blot+ flame haem
- CWS
- OD and Mac edema
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Prognosis of non-isch
- will resovle in 6-12m
- can convert to ischaemic CRVO
- tx inadequate
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Presentation of HRVO?
- sudden onset VF defect
- ~ VA down
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Signs of HRVO?
inf/sup BRVO chnages
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fundus presentation of BRVO?
sup/inf fundus haemorrhages
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Presentation of BRVO?
- ~va?
- sudden
- blurring
- uni
- metamophopsia
- VF defect
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Fundus presentation of BRVO?
- dilation/tortu behind occlusion
- attenuation
- flame/dotblot haem
- retinal edema
- CWS
- sector of retina
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Prognosis of BRVO?
- 6-12m
- good
- collateral vessles-> bypass
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What are vision threatening complications of BRVO
- macular edema- VA
- macular ischaemia
- NVD
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1st line management of RVO macula edema?
intravitreal anti VEGF
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frequency of RVO?
BRVO>CRVO>HRVO
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