What is a central retinal vein occlusion (CRVO)?
Retinal vein occlusion means blockage of a vein in the retina. A central retinal vein occlusion is a blockage of the main (central) vein on the retina. The retina in your eye is like the film inside a camera. The retina “takes the picture” of objects you look at and sends the message to the brain. The retina is a living tissue, which requires blood supplied by tiny vessels. Retinal veins are blood vessels that drain blood from the retina. The veins form as branches that drain sections of the retina. The branch veins all drain into the central retinal vein that exists the eye with the optic nerve. An abnormal blood clot in a retinal vein causes a blockage (occlusion) of the blood flowing out of the retina.
Who is at risk of a central retinal vein occlusion?
Retinal vein occlusions are more common in people who have risk factors for hardening of the arteries, which may compress the veins where they come in contact in the retina. Hardening of the arteries (arteriolar sclerosis) occurs in people who are overweight, use tobacco, or have diabetes, high blood pressure, or sleep apnea. Glaucoma is also a risk factor as intraocular pressure spikes affect blood flow in the retinal veins, and slow blood flow promotes blood clots. There are a number of blood disorders that may play a role in CRVO, especially in younger individuals. Estrogens may increase coagulation of the blood and lead to CRVO. Less commonly, inflammation may cause retinal vein occlusion.
What are the symptoms of a central retinal vein occlusion?
Blurring of vision may occur if excess fluid (edema) leaks from the veins into the center of the retina. Floaters can look like tiny dots or cobwebs moving about in your vision. They may be due to bleeding from the retina into the central gel (vitreous) of the eye. Pain is rare and may be due to high pressure in the eye (neovascular glaucoma).
What treatment is available?
There is no cure, but treatment may improve vision or keep the vision from worsening. Your doctor may allow time for the vein to heal, but this is rarely advisable if the vision is impaired. Medicine injections may help recover vision and may be given with little discomfort. The vision may not return to normal following treatment as there may be some permanent damage to the retina from the occlusion. Injections must be repeated in order to maintain vision. Over time, the retina does heal to some degree. However, after three years of treatment about half of eyes continue to require injections. In some cases when treatment cannot improve the vision, laser is used to prevent severe pain and complete blindness. Your doctor is going to order appropriate tests and recommend the best course of action to take at this time. The retinal vein occlusion will not be worsened by your daily activities or by using your eyes.
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