RETINAL VEIN THROMBOSIS

SYMPTOMS

The symptoms of retinal vein thrombosis may vary depending on the location and extent of the clot and may include:

• Vision Changes: Sudden or gradual onset of blurry vision, partial vision loss (scotoma), or complete vision loss in one eye.
• Floaters: Appearance of dark spots, lines, or cobweb-like shapes (floaters) in the field of vision.
• Visual Field Defects: Peripheral vision loss or visual field defects, such as missing areas or shadows in the visual field.
• Eye Pain: Rarely, individuals may experience eye pain, redness, or discomfort, particularly if there is associated ocular inflammation or elevated intraocular pressure.

Symptoms may be unilateral (affecting one eye) or bilateral (affecting both eyes) and can range from mild to severe, depending on the degree of retinal ischemia and involvement of macular or optic nerve function

DIAGNOSIS

Diagnosing retinal vein thrombosis typically involves a comprehensive eye examination and may include:

• Visual Acuity Testing: Assessment of central vision sharpness using an eye chart to detect any changes in visual acuity.
• Ophthalmoscopy: Examination of the retina and optic nerve using a specialized instrument (ophthalmoscope) to visualize retinal veins, identify areas of hemorrhage or ischemia, and assess macular edema or optic disc swelling.
• Fluorescein Angiography: Injection of a fluorescent dye into the bloodstream followed by retinal imaging to evaluate retinal blood flow, detect vascular abnormalities, and identify areas of non-perfusion or leakage.
• Optical Coherence Tomography (OCT): High-resolution imaging of the retina to assess for macular edema, retinal thickening, or structural changes in the retinal layers.

Additional tests such as blood tests, coagulation studies, or imaging studies (e.g., Doppler ultrasound, magnetic resonance imaging) may be performed to evaluate underlying systemic conditions or identify risk factors for thrombosis.

TREATMENT

Treatment of retinal vein thrombosis aims to preserve vision, prevent complications, and address underlying risk factors. Treatment modalities may include:

• Anticoagulant Therapy: Systemic anticoagulation with medications such as heparin, warfarin, or direct oral anticoagulants (DOACs) may be prescribed to prevent further clot formation and reduce the risk of thromboembolic events.
• Intravitreal Injections: Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections or corticosteroid injections may be used to treat macular edema and reduce retinal vascular leakage.
• Laser Therapy: Focal or grid laser photocoagulation may be performed to treat retinal neovascularization, reduce macular edema, or prevent complications such as vitreous hemorrhage or retinal detachment.
• Surgical Intervention: In cases of severe complications such as neovascular glaucoma or tractional retinal detachment, surgical procedures such as vitrectomy or retinal detachment repair may be necessary.

Treatment decisions are individualized based on the severity of RVT, the presence of macular edema or ischemia, visual acuity, and the underlying systemic condition.