Сentral retinal vein occlusion (CRVO), the first mention of which was made more than 200 years ago, today is characterized by a sufficiently fully and in detail studied pathogenesis and a detailed clinical picture [1]. It should be noted that currently, when studying certain aspects of the pathogenesis of this disease, preference is given to studying the role of various angiogenic factors, in particular, vascular endothelial growth factor (VEGF) [2, 3]. At the same time, the assessment of the influence of coagulation, hemodynamic and immune-inflammatory factors of retinal vein occlusion to a certain extent fades into the background. However, it is a holistic understanding of the pathogenesis of CRVO based on the principles of systemic methodology that is the basis for the development of effective, pathogenetically substantiated methods of treating this disease. Purpose. To study the effectiveness of anti-angiogenic therapy in combination with epiretinal thrombolysis in the treatment of «fresh» CRVO. Methods. A clinical study was conducted among 106 patients with retinal vein occlusion with a disease development period up to 7 days, divided depending on the method of treatment into 2 groups: the main one – 56 patients (56 eyes), who were intravitreally injected with the anti-VEGF drug aflibercept with simultaneous epiretinal injection of recombinant prourokinase, and a comparison group – 50 patients (50 eyes) who received monotherapy with an angiogenesis inhibitor. All patients were matched for age and gender. Ophthalmological examination included: visometry, pneumotonometry, ophthalmoscopy, optical coherence tomography of the macular retina. Statistical processing of the obtained results was carried out using the IBM SPSS Statistics 27 program. Differences were considered statistically significant at p<0.05. Results. The use of a new combined method for thrombosis treatment, including intravitreal injection of an antiVEGF drug in combination with epiretinal injection of prourokinase, provides high and stable clinical and functional results in the postoperative period with an increase in visual acuity by 1.8 times, as well as an acceleration of hemorrhage lysis and resorption of macular edema by 2.0 times. Key words: central retinal vein occlusion; branch central retinal vein occlusion; anti-VEGF therapy; thrombolytics; prourokinase.