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Central Retinal Vein Occlusion

Central retinal vein occlusion (CRVO) is an eye condition that affects the retina and the arteries/veins that carry blood to and from the eyes. When left untreated, CRVO can bring about detrimental and often irreversible damage, so it’s important to be aware of symptoms and to schedule follow-up appointments with your retina specialist in a timely manner.

What Is Central Retinal Vein Occlusion?

Central retinal vein occlusion occurs when the central retinal vein is blocked by a blood clot. Arteries carry blood from the heart to various parts of the body, which is then returned through our veins. The venous circulation in the retina is like a tree with numerous branches, all of which drain into one major vein, the central retinal vein. When the central retinal vein is blocked, the retinal circulation of blood is halted or reduced, producing a backup of blood and fluid into the retinal tissue. An excessive accumulation of fluid is referred to as macular edema, which decreases visual acuity and can cause blurry or distorted vision. 


In most cases, the underlying CRVO causes are hard to pinpoint, and an exact cause is still not entirely known. However, CRVO is more common in patients with high blood pressure, arteriosclerosis, glaucoma, and diabetes. Rarely an underlying clotting disorder may be identified, though in some cases, no clear CRVO cause is found. Your retina specialist will determine the appropriate systemic medical evaluation while taking your age and medical history into consideration.


CRVO showing delayed Retinal Circulation on Angiography

The primary symptom of CRVO is blurry vision, but some individuals with mild CRVO may not experience any symptoms at all. In more severe cases, central retinal vein occlusion symptoms can include pain or redness in the eye, which can range from mild to intense. Since early treatment can significantly help lower the chance of vision loss from CRVO, it’s important to speak with your retina specialist if any of these symptoms arise, even in mild forms.


While there is no direct cure for central retinal vein occlusion, there are CRVO treatment methods available to improve vision and prevent symptoms from progressing further. In terms of improving vision, the only known way to do so is to treat the associated macular edema. CRVO treatment options proven to be effective in reducing macula edema and improving or stabilizing vision include medicines injected into the eye, such as vascular endothelial growth factor (VEGF) inhibitors and certain steroids. These CRVO treatment injections include:

  • Lucentis – FDA approved
  • Eylea – FDA approved
  • Avastin – used off-label
  • Triamcinolone (steroid) – used off-label
  • Ozurdex (steroid) – FDA approved 

Surgery, eye drops, and glasses do not help to improve vision. Sometimes laser treatment is used in conjunction with eye injections.

With time, a minority of patients may experience a spontaneous improvement in vision. However, in most cases, the vision remains the same or worsens without CRVO treatment. The ultimate visual outcome cannot be accurately predicted, but in general, the more severe the occlusion and associated macular edema, the less likely that vision will improve spontaneously. Your retina specialist will review the risks, benefits, and alternatives of the various treatment options with you in further detail and make tailored recommendations based on the unique findings of your eye.

Why Are Follow-up Visits Necessary?

Patients with mild to severe central retinal vein occlusion need to be seen at regular intervals because, in about one-third of all cases, a severe form of glaucoma called neovascular glaucoma develops. In these instances, eye pressure can rise to very high and dangerous levels, which can cause irreversible damage to the optic nerve. If it looks like this is about to occur, laser treatment and/or an injection of a VEGF inhibitor into the eye is necessary. Although these treatments can help prevent or control glaucoma, they do not improve vision. In general, a patient should come back sooner than scheduled if there is ever a marked decrease in vision or eye pain.

If you are experiencing any pain or symptoms related to CRVO, do not hesitate to contact the retinal specialists at Mid Atlantic Retina today. You can request an appointment or call us with any questions or concerns.

CRVO Causes
Central Retinal Vein Occlusion: CRVO Causes, Symptoms, and FAQs