Retina · Medical Retina & AMD

Retinal vein occlusions

A retinal vein occlusion is the blockage of a vein that drains blood from the retina. Blood and fluid accumulate, which can affect vision. Management depends on the type of occlusion and its complications.

Iris and pupil macro photograph

What is a retinal vein occlusion?

A retinal vein occlusion is the blockage of a vein responsible for draining blood from the retina. When this vein becomes occluded, blood and fluid can no longer drain properly and accumulate within the retina, causing haemorrhages and oedema that can impair vision.

It is one of the most common vascular conditions of the retina. Its impact depends on the vein affected and whether complications such as macular oedema develop.

A sudden, painless deterioration in vision should prompt urgent consultation: early management is important.

Central vein occlusion (CRVO) Branch occlusion (BRVO, one sector)
Schematic, non-anatomical illustration: central vein occlusion affects the entire retina; branch occlusion affects only one sector.

Types of occlusion

Two main types are distinguished, according to the level at which the vein is blocked. This distinction determines the impact on vision and the approach to management.

Central retinal vein occlusion (CRVO)

The main vein, at the exit of the optic nerve, is blocked: the entire retina is affected. The loss of vision is often more severe.

Branch retinal vein occlusion (BRVO)

Only one branch vein is blocked: one sector of the retina is affected. The impact on vision depends on the area involved, in particular whether the macula is affected.

Causes and risk factors

Vein occlusion is often associated with systemic vascular risk factors. A general medical workup is therefore usually recommended:

  • arterial hypertension;
  • diabetes and elevated cholesterol;
  • age and certain ocular factors (including glaucoma);
  • less commonly, clotting disorders in younger patients.

Symptoms

The main sign is a deterioration in vision:

  • often sudden and painless;
  • of variable severity depending on the type of occlusion and macular involvement;
  • sometimes preceded by episodes of transient blurred vision.

Diagnosis

Fundus examination and retinal imaging determine the type of occlusion and its consequences, in particular the presence of macular oedema. This is where Dr Gattoussi's expertise in retinal imaging is particularly valuable.

  • Fundus examination: reveals retinal haemorrhages, dilated veins and swelling of the optic nerve;
  • OCT: measures any macular oedema;
  • Angiography: assesses retinal circulation in selected cases.

Management

Treatment depends on the type of occlusion and its complications. The main aim is to treat macular oedema and prevent complications, alongside management of the systemic vascular risk factors.

  1. 1

    Diagnosis and imaging

    Fundus examination, OCT, and angiography if indicated. Screening for associated glaucoma.

  2. 2

    Cardiovascular risk-factor workup

    Assessment of cardiovascular risk factors, with input from the GP and a cardiologist (smoking, cholesterol, diabetes, excess weight, sleep apnoea, high blood pressure), and treatment where needed.

  3. 3

    Treatment

    Intravitreal injections for macular oedema; laser treatment in certain situations.

  4. 4

    Monitoring

    Regular imaging follow-up to detect complications.

Learn more about intravitreal injections

Frequently asked questions

Can a vein occlusion affect both eyes?

It most often affects one eye. A systemic workup is recommended to identify the risk factors and reduce the risk to the other eye.

Can vision recover?

Prognosis depends on the type of occlusion, macular involvement, and management. This is assessed during consultation.

Why consult a GP or cardiologist?

Because the occlusion is often linked to vascular risk factors (blood pressure, diabetes, cholesterol) that need to be managed.

See also

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Ophthalmology practice in Paris 11th. Online appointments via Doctolib, at any time. Sector 2 fees.