What is a branch retinal vein occlusion?
As opposed to a central retinal vein occlusion, a branch retinal vein occlusion occurs when some of the smaller veins of the eye, responsible for carrying blood away from the nerve cells of the retina, become blocked. This blood carries oxygen and nutrients, and if the veins become blocked, you may experience a sudden, painless loss of vision. If the BRVO does not affect veins in the center of the eye, you may have no symptoms at all!
What are the risk factors?
Common risk factors that may contribute to the development of a branch retinal vein occlusion are uncontrolled high blood pressure, obesity, heart disease, glaucoma, and an abnormal tendency to develop blood clots which is more prevalent in younger patients.
How is BRVO diagnosed?
Most of the time, an eye examination showing a retinal hemorrhage, thickened and twisted blood vessels, and retinal edema (swelling with fluid) aid in the diagnosis of BRVO. Additional imaging tests, including fluorescein angiography (FA) and optical coherence tomography (OCT), can also help. FA is able to show fluid leaking from damaged or abnormal retinal vessels and OCT allows for a better look at the central retina which can detect macular edema and fluid outside the macula.
What are the treatment options?
The first step in treating BRVO is addressing the underlying risk factors. This may include monitoring blood pressure and cholesterol levels, and going for additional blood work, if necessary, to determine if you may have some type of clotting disorder.
The next step is to make sure you’re in the hands of a good retina specialist. Treatment of the eye itself is more so to treat retinal complications than to relieve the actual blockage. Macular edema, which is often the reason a branch retinal vein occlusion results in loss of vision, can usually be treated with intraocular (in-the-eye) injections of anti-VEGF drugs which stop the growth of new blood vessels and decrease leakage. In certain cases, laser treatment or steroid injections may be necessary. The anti-VEGF medications consist of Avastin®, Lucentis®, and Eylea®. These often require frequent retreatment which is determined on a case-by-case basis, but patients generally report good results and improvement in vision.
BRVO often carries a good prognosis and some patients don’t require treatment at all if their vision is not effected. Studies have shown that over 60% of patients who are both treated and untreated, maintain vision better than 20/40 after 1 year.
DON’T WAIT! Call (716) 839-9009 to schedule an appointment with Saralyn Notaro Rietz, your Back of the Eye MD! She has over 20 years experience diagnosing and treating diseases of the retina.