A clinical study on management of retinal vascular occlusive disorders

Abstract

Retinal vein occlusion is a retinal vascular disorder due to blockage of retinal vein either, the central retinal vein or any of the branch retinal veins, characterised by engorgement and dilatation of the retinal veins with secondary, mostly intraretinal haemorrhages and intra retinal edema, retinal ischemia including cotton wool spots, retinal exudates and macular edema and is usually associated with a variable degree of visual loss. Retinal vein occlusion is a common cause of vision loss. It is the second most common cause of reduced vision due to retinal vascular disease, after diabetic retinopathy. HISTORY The dramatic picture of retinal vein occlusion was initially described as „retinal apoplexy‟ by Liebreich in 1854. Leber in 1877 reported the first case of BRVO and called it „hemorrhagic retinitis‟. It was first established as a clinical entity due to thrombosis by Julius von Michel in 1878. Koyanagi in 1928 first reported the association between BRVO and AV crossings. CONCLUSIONS Retinal venous occlusions are common in the 6th and 7th decades It is seen more commonly in males. The most common predisposing factor for retinal vein occlusion was hyertension. Branch retinal vein occlusions were commoner than central retinal vein occlusions and had better visual outcomes. All the patients had either same visual acuity or had improvement in visual acuity by 2 or more lines. None of them had worsening of visual acuity by more than 1 line. In our study, 9 patients with macular edema were treated with anti-VEGF and 3 were treated with grid laser. In both these groups, the mean central macular thickness was reduced after treatment. Finally we conclude that In CRVO, final vision is limited despite available treatment. However, regular monitoring is required to detect and treat complications. In BRVO, there is chance for visual improvement in patient with initial good vision