CENTRAL RETINAL VEIN OCCLUSION

Overview of diagnosis and treatment of central retinal vein occlusion.

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The inner layers of the retina receive their blood supply from the central retinal artery. The blood returns to the heart through the central retinal vein. Both vessels enter the eye through a small opening in the middle of the optic nerve. Either because this opening shrinks or because the artery hardens or because of circulations problems, the central retinal vein can become partially or completely occluded. When a patient develops a central retinal vein occlusion (CRVO), they lose some or most of their central vision. The photograph of the retina on the right is of an eye with 20/50 visual acuity with a central retinal vein occlusion for 6 weeks. The retinal veins dilate and there are retinal hemorrhages. Patients often develop swelling of the central retina-cystoid macular edema–causing some of the vision loss. Without treatments, 25% of eyes improve, 50% stabilize, and 25% worsen.

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Monthly Lucentis therapy is also helpful in improving vision in patients with central retinal vein occlusion and macular edema. Without treatment about 15 percent of have visual improvement. With treatment about 50 percent of patients have improved vision. Long term follow-up show that at 4 years, a little over half of the patients with central retinal vein occlusion require continued treatment to maintain the visual benefit.

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Monthly Eylea therapy is also helpful in improving vision in patients with central retinal vein occlusion and macular edema. Without treatment about 15 percent of have visual improvement. With treatment about 60 percent of patients have improved vision.

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