10a. Retinal Venous Occlusions

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Author:
sookylala
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235322
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10a. Retinal Venous Occlusions
Updated:
2013-11-09 00:34:23
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retinal occlusions
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retinal occlusions
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  1. Retinal venous occlusions affects/features/classifications?
    • common
    • >50yo
    • CRVO, HRVO, BRVO
    • venous occlusion-> venous stasis-> vessel damage-> ischaemia-> haemorrhage and edema
  2. What are the most common predisposing factors for RVOs?
    old age, hypertnesion, cholesterol, diabetes, smoking, raised IOP
  3. Pathogenosis of CRVO?
    • obstruction: thrombus in CRV, arteriosclerosis of CRA-> increases flow to CRV
    • OR: compressive/inflammatory ON/orbital problems (structural abnorms in lamcrib)-> lead to CRV thrombosis
  4. pathogenosis of BRVO?
    • compression of vein by crossing artery
    • venous occlusion-> stasis-> ischaemia-> damage to retinal tissues-> hamemorrhage, edema
  5. Pathogenisis of HRVO?
    • variant of CRVO
    • occlusion of sup/inf branch of CRV
    • HCRVO: involves one trunk- congenital
  6. What is the typical presentation of an RVO?
    • uni, painless loss of VA
    • asx
  7. medical investigations for RVO?
    BP, ECG, C reactive protein, chest x ray
  8. ocular investigations for RVO?
    • RAPD
    • VF
    • FA
    • CV
    • Gonio
    • OCT
    • ERG/VEP
  9. Why and where do haemorrhages occur in CRVO?
    • NFL
    • new vessels where supply is lost: leaky
    • NVD/NVI ischaemic
  10. Is RAPD seen in ischaemic or non ischaemic?
    ischaemic- related to marked retinal pathology
  11. Which is more common Isch or non isch CRVO?
    • ischaemic CRVO: 20-30%
    • non ischaemic: 80-70%
  12. Signs of Ischaemic CRVO?
    • rapid onset venous occlusion, decreased of retinal perfusion, capillary occlusion, retinal hypoxia
    • sudden severe loss of vision- macula edema
    • RAPD
  13. prognosis of ischaemic CRVO?
    • poor due to mac ischaemia
    • red iris develops
    • glaucoma
  14. TX of ischaemic CRVO?
    laser to prevent NVG
  15. What is the fundus presentation of ischaemic CRVO?
    • tortuosity and engorg of CRV branches
    • extensive haem
    • CWS
    • Macular edema
    • hyperaemia
  16. Presentation of NOn-ischaemic CRVO?
    sudden painless mild-mod loss of VA
  17. Fundus presentation of non-ischaemic CRVO?
    • tortous and engorgement of CRV branches
    • dot blot+ flame haem
    • CWS
    • OD and Mac edema
  18. Prognosis of non-isch
    • will resovle in 6-12m
    • can convert to ischaemic CRVO
    • tx inadequate
  19. Presentation of HRVO?
    • sudden onset VF defect
    • ~ VA down
  20. Signs of HRVO?
    inf/sup BRVO chnages
  21. fundus presentation of BRVO?
    sup/inf fundus haemorrhages
  22. Presentation of BRVO?
    • ~va?
    • sudden
    • blurring
    • uni
    • metamophopsia
    • VF defect
  23. Fundus presentation of BRVO?
    • dilation/tortu behind occlusion
    • attenuation
    • flame/dotblot haem
    • retinal edema
    • CWS
    • sector of retina
  24. Prognosis of BRVO?
    • 6-12m
    • good
    • collateral vessles-> bypass
  25. What are vision threatening complications of BRVO
    • macular edema- VA
    • macular ischaemia
    • NVD
  26. 1st line management of RVO macula edema?
    intravitreal anti VEGF
  27. frequency of RVO?
    BRVO>CRVO>HRVO

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