English

Abstract

INTRODUCTION: Retinal vein occlusion is the most common retinal occlusive disorder encountered by Ophthalmologists and is usually associated with a variable amount of visual loss. This is the second most common retinal vascular disease next to diabetic retinopathy. Liebreich initially described dramatic obstruction of veins as retinal apoplexy. Leber(1) (1877) reported the first case of BRVO and called it Hemorrhagic retinitis. RVO most commonly affects the venous blood supply of the entire retina (CRVO) or a quadrant drained by one of the branches (BRVO) or less commonly the superior or inferior half of the retina alone is affected (HCRVO). For discussion and management purpose RVO is broadly classified into six clinical entities includes (1) Non-ischemic CRVO (2) Ischemic CRVO (3) Non ischemic HCRVO (4)Ischemic HCRVO (5) Major BRVO (6)Macular BRVO. So much of confusion still exists regarding its natural history, degree of severity, management and its progression. The clinical study of RVO is taken up mainly with a view to study the importance of systemic risk factors in etiopathogenisis of RVO, to study the clinical features and effectiveness of treatment in modification of the natural course and complications of RVO. Depending on type of venous occlusion patient may present with long of central vision frequently noticed on waking of in the morning, or field contraction, erythropsia, floates, black spots. Episodes of amaurosis fugax lasts for minutes to hours may be present. There may be metamorphopsia. Signs of decreased visual acuty, RAPD, visual field defects are observed. Fundus picture shows Retinal hemorrhages distributed based on type of venous occlusion. In ischemic CRVO the picture shows “berries on a twig”. Various sequel & complications include macular edema, anterior segment and retinal neovascularisation, vitreous hemorrhage, retinal detachment may be encountered. Various risk factors include Hypertension, Diabetes, Hyperlipidemia, IHD, rental disease. The first sign proving an ischemic CRVO is neovascular disease of the iris. Untreated rubeosisiridis may lead to occlusion of the chamber angle with secondary glaucoma and hyphema.