Macular oedemas in cases of
branch and central retinal vein occlusion

Branch retinal vein occlusion commonly occurs when a blood clot blocks a vein in the eye. This “clot” can be triggered by different factors: In most cases it is caused by an elevated blood pressure and the concomitant atherosclerosis (disease in which plaque builds up inside your arteries). But also smoking and diabetes constitute risk factors.

Depending on the exact location, we either speak of a branch retinal vein occlusion (BRVO) or a central retinal vein occlusion (CRVO).

Branch retinal vein occlusions are much more common than central retinal vein occlusions: In 85% of all cases of retinal vein occlusion, we will be dealing with a BRVO. In general, the risk of suffering a vein occlusion increases considerable with age. Nearly all patients are over 50 years old.

Branch retinal vein occlusion (BRVO)

Diagnosis of branch retinal vein occlusion/central retinal vein occlusion

In most cases, an examination of the fundus with the slit lamp will result in a diagnosis. An additional imaging of the vessels (fluorescence angiography) enables us to distinguish between a vein occlusion in which the smallest vessels are still supplied with blood (non-ischemic form) and vein occlusion with an occluded capillary bed (ischemic form).

Slit lamp exam
Fluorescence angiography

Treatment of vein occlusions

The cause of vein occlusions cannot be treated. All therapeutic measures are designed to limit the loss of vision as far as possible and to avoid complications at a later point.

For many years, laser treatment was considered the gold standard in this context. Today, it is only performed in selected cases to reduce the swelling.

Today, the standard treatment focuses on medication which are administrated to the eye directly by means of intravitreal injection. VEGF blockers have proven to be highly successful for combating retinal swelling within the scope of other macular diseases and will result in a noticeable reduction of the swelling after repeat administration.

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