Central Retinal Vein Occlusion

Central retinal vein occlusion (CRVO) is a common cause of marked or total loss of vision in the middle-aged and elderly population, but no age group is immune to it. Although the disease entity has been known since 1878 and a large volume of literature has been published on the subject, its management is still ill-understood and controversial.

Since 1963 I have done experimental and clinical research on CRVO, its various types, course of the disease and various management options available and their merits and demerits. The following is a brief summary of my experience based on these studies and my way of managing CRVO

Types of Central Retinal Vein Occlusion

My studies showed that CRVO is actually of two types, with very different prognoses and management.^1-3 The two types are:

• Non-ischemic type or venous stasis retinopathy.
• Ischemic type or hemorrhagic retinopathy.

Classification of CRVO into non-ischemic and ischemic CRVO is essential because non-ischemic CRVO is a comparatively benign disease, with permanent central scotoma as the major complication from cystoid macular edema (see below). This type of CRVO does not develop the most dreaded complication of ocular neovascularization. In contrast to that, ischemic CRVO is a seriously blinding disease, and anterior segment neovascularization leading to neovascular glaucoma is its major complication (see below).