1 / 11

RETINAL VEIN OCCLUSION

RETINAL VEIN OCCLUSION. Epidemiology. 51% >65y 10-15% <45y  ν Afro-caribbean and Asian descent in UK. Pathogenesis Primary retinal venous disease/ endothelium Thrombus secondary event (Hypercoaguability). AETIOLOGICAL CONDITIONS. DIAGNOSIS. Painless loss of vision- unilateral

bridie
Download Presentation

RETINAL VEIN OCCLUSION

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. RETINAL VEIN OCCLUSION Epidemiology 51% >65y 10-15% <45y ν Afro-caribbean and Asian descent in UK • Pathogenesis • Primary retinal venous disease/ endothelium • Thrombus secondary event (Hypercoaguability)

  2. AETIOLOGICALCONDITIONS

  3. DIAGNOSIS • Painless loss of vision- unilateral • Asymptomatic

  4. BRVO Arteriovenous crossings Macular branch (DD from diabetic maculopathy)

  5. CRVO

  6. MECHANISMS OF VISUAL LOSS Ischaemic (direct- indirect) Exudative (macular oedema) 30% non-isch. Convert to ischaemic type first 4/12 Eyes at High Risc for Ischaemic Complications 1.RAPD 2.  VA 3. FFA >10DD, 5-10 DD 4.Cotton wool spots >10, 5-10 5. Deep dark haem. (infarct) 6. Elderly ( rubeosis)

  7. DIFFERENTIAL DIAGNOSIS 1.Accelerated hypertension 2.DM 3.Slow-flow retinopathy 4.Peripapillary telangiectasia 5. AION 6.Lupus/ radiation retinopathy 7. CMV retinitis 8.Ocular ischaemic syndrome

  8. MEDICAL INVESTIGATIONS ALL PATIENTS FBC, ESR, U&E, LFT, GLC, Lipid profile Protein electrophoresis ECG TFT MORE SPECIALISED CXR Cardiolipin, Lupus anticoagulant CRP, ACE, FTA-ABS RF, ANA, DNA, ANCA MRI: orbit, brain

  9. MANAGEMENT OCULAR BRVO Argon laser for macular oedema if foveal vasculature intact (FFA), VA 6/12-6/60 3-6/12 after the initial event Sectoral PRP for proliferative complications or if areas of non-perfusion >5DD FU: 6/52, up to 2years after (collaterals)

  10. CRVO Prevention of neovascularisation Grid: no benefit FFA and Laser: haemorrhages sufficiently resolved Monthly FU/ total of 2years >40DD: PRP 10-40DD: no <10 (non-ischaemic): no Non-ischaemic cases convert to ischaemic 13%: 6/12 18%: 18/12 CHECK RAPD ALWAYS IN FU

  11. MEDICAL • Maximise visual outcome •  cardiovascular morbidity/ mortality (risk factors) • Prevent recurrence to other eye (15% over 5 years) + Aspirin/ dipyridamole

More Related