Retinal Vein Occlusion Treatment | Pristyn Care

Risk Factors

Risk factors for retinal vein occlusion development:

• Age over 50 years – RVO incidence increases significantly with age
• Uncontrolled hypertension, the primary modifiable risk factor for RVO
• Diabetes with poor glycemic control affecting retinal vascular health
• Glaucoma or elevated intraocular pressure compressing the central retinal vein
• Thrombophilic conditions increasing blood clot formation in retinal vessels
• Oral contraceptive use in women increasing thrombotic risk

Candidacy

All patients diagnosed with RVO causing macular edema or visual loss should be evaluated for treatment. Anti-VEGF injections are the primary treatment for macular edema from both BRVO and CRVO. Ischemic RVO causing peripheral non-perfusion may require laser photocoagulation to prevent neovascular complications. Systemic risk factor control is a critical component of all RVO treatment plans.

Diagnosis

Diagnostic evaluation for retinal vein occlusion includes:

• Dilated fundus examination to identify retinal hemorrhages, disc edema, and cotton wool spots
• Optical coherence tomography (OCT) to measure and monitor macular edema
• Fluorescein angiography to assess retinal perfusion and identify ischemic zones
• OCT angiography for non-invasive retinal vascular mapping
• Systemic workup including blood pressure, blood glucose, and coagulation profile

Treatment Options

Treatment for RVO focuses on managing macular edema and preventing neovascular complications. Anti-VEGF injections (ranibizumab, bevacizumab, aflibercept) are the first-line treatment for macular edema. Intravitreal dexamethasone implants offer a longer-acting steroid option. Laser photocoagulation treats ischemic areas to prevent neovascularization. Vitrectomy may be considered for vitreous hemorrhage or tractional complications from RVO-related proliferative disease.

RVO Treatment Procedure Steps

Treatment for retinal vein occlusion at Pristyn Care involves the following approaches:

• Anti-VEGF injections (intravitreal) administered monthly for 3 to 6 months initially, then as needed
• Intravitreal dexamethasone implant (Ozurdex) for patients preferring less frequent dosing
• Laser photocoagulation performed for ischemic RVO with peripheral non-perfusion
• Grid laser for diffuse macular edema in selected BRVO cases
• Vitrectomy with membrane peeling for tractional macular edema or vitreous hemorrhage
• Systemic risk factor management including blood pressure and diabetes optimization
• Regular monitoring with OCT and visual acuity testing to guide re-treatment decisions

Recovery After Treatment

Follow-up and monitoring after RVO treatment includes:

• Monthly clinic visits for OCT monitoring and injection decisions in the initial treatment phase
• Visual improvement typically occurs over 1 to 3 months after anti-VEGF injections
• Ongoing maintenance injections required to prevent macular edema recurrence
• Regular fundus examination to monitor for neovascular complications
• Systemic risk factor control maintained throughout the treatment period
• Long-term follow-up as RVO can cause late complications years after the initial event

Risks and Complications of RVO Treatment

Potential complications of retinal vein occlusion and its treatment include:

• Permanent central vision loss from chronic macular edema or macular ischemia
• Neovascular glaucoma from iris neovascularization, especially in CRVO
• Vitreous hemorrhage from retinal neovascularization requiring vitrectomy
• Retinal detachment from tractional fibrovascular proliferation
• Endophthalmitis from intravitreal injection – rare but serious complication
• Increased intraocular pressure from intravitreal steroid treatment
• Cataract progression associated with repeated intravitreal steroid injections
• Fellow eye involvement – RVO may develop in the second eye with ongoing risk factors