Daily Bolus of LR: Central Retinal Vein Occlusion

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November 2, 2011 by dailybolusoflr

Central Retinal Vein Occlusion (CRVO)

* Is a frequent cause of visual loss in patients over 50 years old
* Associated risk factors include: hypertension, diabetes and open angle glaucoma
* Younger patients with this disorder usually have an associated inflammatory condition or coagulopathy
* Patients present with sudden onset of unilateral and painless vision loss or alteration in vision
* Fundoscopic exam will show the characteristic “blood and thunder” appearance, which is representative of diffuse retinal hemorrhages with radiate out from the optic nerve. Cotton wool spots (microinfarctions) can be seen and the optic nerve and macula may show edema.
* CRVO is classified into two types: Ischemic and Non-ischemic
* Non-ischemic is the more common type and is 3/4 of all cases. These patients typically present with more preserved visual acuity, lack of cotton wool spots and lack of an APD
* Ischemic is the less common type and typically presents with more severe findings including worse visual acuity, the presence of cotton wool spots, a higher incidence of edema of the macula and optic nerve and an APD
* Management long-term is aimed at preventing complications associated with neovascularization which can lead to glaucoma
* Acute management often involves the initiation of daily aspirin, if safe; anticoagulation or anti-inflammatory agents in patients with known coagulopathy or inflammatory conditions and expeditious follow up with ophthalmology
* A picture can be seen here http://www.acponline.org/mobile/ophthalmologywaxman2011/crvo.html

Ref: Curr Opin Ophthalmol 2011. 22:159-165

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