This retinal disease commonly occurs in patients over 60 years of age. After diabetic retinopathy it is the most frequently encountered retinal vascular pathology. Systemic conditions may favour its development, such as cardiovascular diseases, arterial hypertension, diabetes, excessive cholesterol and other anomalies of the blood.
Veinous thrombosis may involve only a segment of the retina because a branch of the veinous system has been affected. If the entire retina is affected, the central vein of the retina has been occluded.
Visual acuity is diminished but in varying degrees from eye to eye. Examination of the fundus reveals retinal hemorrhages, tortuous veins and oedema of the optic nerve. There are two types of central veinous occlusion : ischemic and non-ischemic. Prognosis for the former is poor. They are distinguished by reference to visual acuity, fundus and especially fluoresceine angiography.
In half of the cases normal visual acuity is recovered. Unfortunately this is not true for ischemic occlusions : poor visual recuperation is accompanied by increased risk of complications, such as neovascularisations, which are new blood vessels formed in the retina - where they can cause bleeding - and formed in the iris - where they can obstruct the trabeculum (the filter of the intra-ocular fluid) causing increased eye pressure and glaucoma.
Care must be taken to protect the other eye, namely by identifying possible causes. Often blood-thinning medication is initiated.
Ischemic veinous thrombosis is dealt with by laser treatment of the peripheral retina to avoid complications such as rubeosis iridis (=abnormal bloodvessels at the level of the iris) and neovascular glaucoma.
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