Pathogenesis, prevention, diagnosis and management of retinal vein occlusion

Abstract

Retinal vein occlusion (RVO) is the second vascular retinal cause of visual loss and defined by the occlusion of a retinal vein. It is divided into branch retinal vein occlusion or central retinal vein occlusion, depending on the location of occlusion. RVO has severe medical, financial and social implications on the patients. The diagnosis of the disease is easier nowadays with the use of spectral domain optical coherence tomography and fluorescein angiography. The treatment options for RVO have changed dramatically over the past few years with the introduction of the intravitreal injections of dexamethasone (Ozurdex), bevacizumab (Avastin), ranibizumab (Lucentis) and aflibercept (EYLEA), along with the panretinal laser photocoagulation, abandoning former treatment modalities and surgical solution. This manuscript is a review of current literature about RVO with emphasize on the pathophysiology, risk factors and prevention, diagnosis and sub-group categorization and treatments including medical and surgical. Since no official guidelines are available for the treatment of RVO patients, and considering the latest developments in the treatment options, and the variety of follow-up and treatment modalities, this manuscript aims to provide tools and knowledge to guide the physician in treating RVO patients, based on the latest publications from the literature and on several of the patients characteristics.

Keywords: Retinal vein occlusion, Pathophysiology, Prevention, Diagnosis, Treatment

Core tip: Retinal vein occlusion (RVO) is the second vascular retinal cause of visual loss and is defined by the occlusion of a retinal vein. The diagnosis of the disease is easier with the common use of spectral domain optical coherence tomography and fluorescein angiography. The treatment options for RVO, has changed over the past years with the introduction of the intravitreal injections of dexamethasone (Ozurdex), bevacizumab (Avastin), ranibizumab (Lucentis) and aflibercept (EYLEA). This manuscript is a review of current literature about RVO and provides tools and knowledge to guide the physician in treating patients.