Central retinal vein occlusion

Background

1. Risk Factors
   1. DM
   2. HTN
   3. Hypercoagulable states
   4. Vasculitis
   5. Glaucoma

Clinical Features

1. Loss of vision
   1. Variable, ranging from vague blurring to rapid, painless monocular vision loss

Diagnosis

1. Fundoscopy
   1. Optic disc edema, dilated and tortuous veins, diffuse retinal hemorrhages ("blood-and-thunder fundus")

Differential Diagnosis

Acute Vision Loss (Noninflamed)

• Painful
  • Arteritic anterior ischemic optic neuropathy
  • Optic neuritis
  • Temporal arteritis^†
• Painless
  • Amaurosis fugax
  • Central retinal artery occlusion (CRAO)^†
  • Central retinal vein occlusion (CRVO)^†
  • High altitude retinopathy
  • Open-angle glaucoma
  • Posterior reversible encephalopathy syndrome (PRES)
  • Retinal detachment^†
  • Stroke^†
  • Vitreous hemorrhage
  • Traumatic optic neuropathy (although may have pain from the trauma)

^†Emergent Diagnosis

Treatment

1. Consult ophtho and neuro
2. Complex treatment involving lowering IOP, topical steroids, cyclocryotherapy, photocoagulation while managing underlying medical diseases

See Also

Acute Vision Loss (Noninflamed)

Source

Tintinalli

Rosen's