Dr. David Maberley, MD, FRCSC, Ophthalmologist
Duration: 3 minutes and 20 seconds
Confirming a diagnosis require a retinal examination. Your ophthalmologist or an eye care specialist will be able to diagnose the retinal vein occlusion by the appearance of hemorrhages in the retina. The types of hemorrhages that are there including changes to the blood vessels in the back of the eye will also help with an accurate diagnosis. Pictures such as laser photographs of the central retina can help show a fluid accumulation which is often the main reason for blurred central vision in this condition.
Sometimes, a dye can be injected into a patient's arm and pictures of the dye circulating in the back of the eye are helpful to confirm the diagnosis. This is called a fluorescein angiogram.
Treatments are first directed at determining if there are underlying risk factors for the development of the vein occlusion. In younger patients, sometimes there needs to be hematologic evaluation for clotting abnormalities. In older patients, it's important to check risk factors such as blood pressure, kidney function, cholesterol levels and diabetes as potential factors that are contributing to this condition.
Checking potential risk factors that could make a vein occlusion worse and ensuring they are adequately controlled is important. Once the patient is assessed and we know that they've been stabilized from a general medical standpoint, the typical treatment would depend on the severity of the vein occlusion and the type of problems that develop after the vein occlusion develops.
The most common complication that affects vision is swelling in the macula called macular edema and can occur both with a central and a branch retinal vein occlusion. If that occurs, ocular treatment is typically an injection that goes directly in the eye called an anti VEGF medicine. This is injected into the eye periodically to control and reduce the swelling in the retina and typically improve the efficiency.
There's another complication that can develop in retinal vein occlusions where the retina loses blood supply and starts to grow abnormal vessels in the retina called new neovascular retinal vessels. Those vessels can contract and bleed and fill the eye up with blood. In this situation, similar injections are often of benefit to cause those abnormal blood vessels to shrink and go away. However, if the bleeding is significant then sometimes surgery is needed to remove the blood from the eye. Laser can also be used in areas of significantly damaged retina to reduce the risk of these new blood vessels from growing and causing bleeding in the into the eyeball itself.
If you think you are at risk of retinal vein occlusion and would like to be screened for the condition, you should visit your local eye specialist.
Presenter: Dr. David Maberley, Ophthalmologist, Ottawa, ON
Local Practitioners: Ophthalmologist
