Central retinal vein occlusion

Background

CRVO Blood and Thunder

Risk Factors

• DM
• HTN
• Hypercoagulable states
• Vasculitis
• Glaucoma

Clinical Features

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

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

Diagnosis

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

Management

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

See Also

Acute Vision Loss (Noninflamed)