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Retinal blood vessel occlusion

Summary

Retinal blood vessel occlusion

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The eye has an extensive network of blood vessels that carry fresh oxygenated blood to the retina and then take the waste and deoxygenated blood away. 

The vessels are very narrow, particularly in the retina and they can become blocked with blood clots. This condition is described as retinal blood vessel occlusion.

Types of retinal blood vessel occlusion

Retinal artery occlusion

The retinal arteries, like all other arteries in the body, are prone to a build up of fatty plaques. This process is atherosclerosis. Just as in the coronary arteries of the heart, a narrowed artery causes blood to flow more slowly, increasing the risk of clots. If a clot occurs, the part of the retina beyond the clot is starved of oxygen. The receptor cells are delicate and if this lasts even a few minutes, they cannot recover.

Retinal vein occlusion

Retinal veins can also deteriorate with age, becoming distended. Blood again flows through them more slowly, leading to clots that can block the vein. Blood can then no longer leave the eye quickly enough and it pools in the retina, causing swelling and damage.

Symptoms of retinal vessel occlusion

Retinal artery occlusion is a dramatic, with complete sight loss in one eye that tends to come on very suddenly. It may be for only a few seconds, or it can be more long lasting. Urgent action is required and you need to go to A&E so that blood-thinning medication can be given to prevent complete loss of vision in the eye that is affected.

Renal vein occlusion is more gradual. Usually it also only affects one eye but rather than a sudden loss of vision, eyesight reduces more slowly as the swelling develops. Again, prompt treatment can help prevent serious vision loss.

Diagnosing retinal vessel occlusion

Signs of retinal artery and retinal vein occlusion can be detected by looking at the back of the eye using a slit lamp microscope. Two other diagnostic techniques are also often used:

  • Fluorescein angiography: a dye that shows up well on an X-ray is injected into a vein in the arm. This travels through the blood vessel network of the body. As it goes through the blood vessels in the eye, X-rays of the patient’s head reveal the location of the blockage and the damage it is causing. This technique can also reveal new blood vessel growth.
  • Optical coherence tomography: this is a complex 3D mapping technique that measures the thickness of the retina, and particularly the macula, using diagnostic images. Even tiny changes in thickness indicate serious swelling.

Treatment for retinal artery occlusion

Apart from blood thinners given to try to break down the clot quickly, retinal artery occlusion cannot really be treated. If the clot breaks down and blood supply is restored, there can be small improvements in vision and no further loss of sight. You may also be given treatments to help with underlying health problems such as high blood pressure or high cholesterol.

Treatment for retinal vein occlusion

This is a slower process and several treatments have been approved, some quite recently, to reduce the impact of swelling and fluid build up, so helping to save vision. 

Injections into the eye can help. The drugs used vary; steroids and drugs that target vascular endothelial growth factor (VEGF) can help. Other drugs target different molecules that stimulate inflammation and more are likely to become available in the next few years.

Surgery for retinal vein occlusion

Laser surgery can help prevent further sight loss by reducing inflammation in the macula, the central region of the retina, and by targeting new blood vessel growth.

If a retinal vein becomes blocked, one of the ways the eye tries to protect itself is by growing new blood vessels to navigate around the blockage. These are formed randomly and can break through layers in the retina, causing further damage.

Lasers can be used to stop these blood vessels from growing, preventing this secondary damage.

Moorfields Private

Interested in getting private eye surgery?

Download our free 48 page PDF guide

Sponsored by Moorfields Private Eye Hospital

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