Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Central Retinal Vein Occlusion Differential Diagnoses

  • Author: Lakshmana M Kooragayala, MD; Chief Editor: Douglas R Lazzaro, MD, FAAO, FACS  more...
 
Updated: Jun 29, 2016
 
 
 
Contributor Information and Disclosures
Author

Lakshmana M Kooragayala, MD Vitreo-retinal Surgeon, Marietta Eye Clinic

Lakshmana M Kooragayala, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Steve Charles, MD Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Macula Society, Retina Society, Club Jules Gonin

Disclosure: Received royalty and consulting fees for: Alcon Laboratories.

Chief Editor

Douglas R Lazzaro, MD, FAAO, FACS Chairman, Professor of Ophthalmology, The Richard C Troutman, MD, Distinguished Chair in Ophthalmology and Ophthalmic Microsurgery, Department of Ophthalmology, State University of New York Downstate Medical Center; Chief of Ophthalmology, Director of Cornea, Director of Surgical Training, Kings County Hospital Center

Douglas R Lazzaro, MD, FAAO, FACS is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Society of Cataract and Refractive Surgery, Association for Research in Vision and Ophthalmology, Association of University Professors of Ophthalmology, Brooklyn Ophthalmological Society, Cornea Society, New York Society for Clinical Ophthalmology, Ophthalmic Laser Surgical Society

Disclosure: Nothing to disclose.

Additional Contributors

V Al Pakalnis, MD, PhD Professor of Ophthalmology, University of South Carolina School of Medicine; Chief of Ophthalmology, Dorn Veterans Affairs Medical Center

V Al Pakalnis, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, South Carolina Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the assistance of Ryan I Huffman, MD, with the literature review and referencing for this article.

References
  1. Central Vein Occlusion Study Group. Natural history and clinical management of central retinal vein occlusion. [published erratum appears in Arch Ophthalmol 1997 Oct;115(10):1275]. Arch Ophthalmol. 1997 Apr. 115(4):486-91. [Medline].

  2. Hayreh SS. Classification of central retinal vein occlusion. Ophthalmology. 1983 May. 90(5):458-74. [Medline].

  3. Hayreh SS. Retinal vein occlusion. Indian J Ophthalmol. 1994 Sep. 42(3):109-32. [Medline].

  4. Hayreh SS, Zimmerman MB, Podhajsky P. Incidence of various types of retinal vein occlusion and their recurrence and demographic characteristics. Am J Ophthalmol. 1994 Apr 15. 117(4):429-41. [Medline].

  5. Williamson TH. Central retinal vein occlusion: what's the story?. Br J Ophthalmol. 1997 Aug. 81(8):698-704. [Medline].

  6. David R, Zangwill L, Badarna M, et al. Epidemiology of retinal vein occlusion and its association with glaucoma and increased intraocular pressure. Ophthalmologica. 1988. 197(2):69-74. [Medline].

  7. Ota M, Tsujikawa A, Kita M, et al. Integrity of foveal photoreceptor layer in central retinal vein occlusion. Retina. 2008 Nov-Dec. 28(10):1502-8. [Medline].

  8. Klein R, Moss SE, Meuer SM, et al. The 15-year cumulative incidence of retinal vein occlusion: the Beaver Dam Eye Study. Arch Ophthalmol. 2008 Apr. 126(4):513-8. [Medline].

  9. Mitchell P, Smith W, Chang A. Prevalence and associations of retinal vein occlusion in Australia. The Blue Mountains Eye Study. Arch Ophthalmol. 1996 Oct. 114(10):1243-7. [Medline].

  10. Central Vein Occlusion Study Group. Baseline and early natural history report. Arch Ophthalmol. 1993 Aug. 111(8):1087-95. [Medline].

  11. Glacet-Bernard A, les Jardins GL, Lasry S, Coscas G, Soubrane G, Souied E, et al. Obstructive sleep apnea among patients with retinal vein occlusion. Arch Ophthalmol. 2010 Dec. 128(12):1533-8. [Medline].

  12. Baxter GM, Williamson TH. Color Doppler flow imaging in central retinal vein occlusion: a new diagnostic technique?. Radiology. 1993 Jun. 187(3):847-50. [Medline].

  13. Moschos MM, Moschos M. Intraocular bevacizumab for macular edema due to CRVO. A multifocal-ERG and OCT study. Doc Ophthalmol. 2008 Mar. 116(2):147-52. [Medline].

  14. Gupta B, Grewal J, Adewoyin T, et al. Diurnal variation of macular oedema in CRVO: prospective study. Graefes Arch Clin Exp Ophthalmol. 2008 Dec 4. [Medline].

  15. Kashani AH, Lee SY, Moshfeghi A, Durbin MK, Puliafito CA. OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF RETINAL VENOUS OCCLUSION. Retina. 2015 Nov. 35 (11):2323-31. [Medline]. [Full Text].

  16. Breton ME, Quinn GE, Keene SS, et al. Electroretinogram parameters at presentation as predictors of rubeosis in central retinal vein occlusion patients. Ophthalmology. 1989 Sep. 96(9):1343-52. [Medline].

  17. Sato E, Yamamoto S, Ogata K, et al. Changes of electroretinogram without improvement of retinal circulation after radial optic neurotomy for central retinal vein occlusion. ERG changes after RON for CRVO. Doc Ophthalmol. 2008 Mar. 116(2):153-8. [Medline].

  18. Green WR, Chan CC, Hutchins GM. Central retinal vein occlusion: a prospective histopathologic study of 29 eyes in 28 cases. Retina. 1981. 1:27-55.

  19. Yeh S, Kim SJ, Ho AC, Schoenberger SD, Bakri SJ, Ehlers JP, et al. Therapies for macular edema associated with central retinal vein occlusion: a report by the American Academy of Ophthalmology. Ophthalmology. 2015 Apr. 122 (4):769-78. [Medline]. [Full Text].

  20. Ip MS, Scott IU, VanVeldhuisen PC, et al. A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with observation to treat vision loss associated with macular edema secondary to central retinal vein occlusion: the Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) study report 5. Arch Ophthalmol. 2009 Sep. 127(9):1101-14. [Medline]. [Full Text].

  21. Aref AA, Scott IU, Oden NL, Ip MS, Blodi BA, VanVeldhuisen PC, et al. Incidence, Risk Factors, and Timing of Elevated Intraocular Pressure After Intravitreal Triamcinolone Acetonide Injection for Macular Edema Secondary to Retinal Vein Occlusion: SCORE Study Report 15. JAMA Ophthalmol. 2015 Sep. 133 (9):1022-9. [Medline]. [Full Text].

  22. Haller JA, Bandello F, Belfort R Jr, et al. Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion. Ophthalmology. 2010 Jun. 117(6):1134-1146.e3. [Medline].

  23. Brown DM, Campochiaro PA, Singh RP, Li Z, Gray S, Saroj N, et al. Ranibizumab for macular edema following central retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology. 2010 Jun. 117(6):1124-1133.e1. [Medline].

  24. Kinge B, Stordahl PB, Forsaa V, Fossen K, Haugstad M, Helgesen OH, et al. Efficacy of ranibizumab in patients with macular edema secondary to central retinal vein occlusion: results from the sham-controlled ROCC study. Am J Ophthalmol. 2010 Sep. 150(3):310-4. [Medline].

  25. Varma R, Bressler NM, Suñer I, Lee P, Dolan CM, Ward J, et al. Improved Vision-Related Function after Ranibizumab for Macular Edema after Retinal Vein Occlusion: Results from the BRAVO and CRUISE Trials. Ophthalmology. 2012 Jul 17. [Medline].

  26. Spaide RF, Chang LK, Klancnik JM, et al. Prospective Study of Intravitreal Ranibizumab as a Treatment for Decreased Visual Acuity Secondary to Central Retinal Vein Occlusion. Am J Ophthalmol. 2008 Oct 17. [Medline].

  27. Heier JS, Campochiaro PA, Yau L, Li Z, Saroj N, Rubio RG, et al. Ranibizumab for macular edema due to retinal vein occlusions: long-term follow-up in the HORIZON trial. Ophthalmology. 2012 Apr. 119 (4):802-9. [Medline]. [Full Text].

  28. Larsen M, Waldstein SM, Boscia F, Gerding H, Monés J, Tadayoni R, et al. Individualized Ranibizumab Regimen Driven by Stabilization Criteria for Central Retinal Vein Occlusion: Twelve-Month Results of the CRYSTAL Study. Ophthalmology. 2016 May. 123 (5):1101-11. [Medline]. [Full Text].

  29. Boyer D, Heier J, Brown DM, Clark WL, Vitti R, Berliner AJ, et al. Vascular endothelial growth factor Trap-Eye for macular edema secondary to central retinal vein occlusion: six-month results of the phase 3 COPERNICUS study. Ophthalmology. 2012 May. 119(5):1024-32. [Medline].

  30. Ogura Y, Roider J, Korobelnik JF, Holz FG, Simader C, Schmidt-Erfurth U, et al. Intravitreal aflibercept for macular edema secondary to central retinal vein occlusion: 18-month results of the phase 3 GALILEO study. Am J Ophthalmol. 2014 Nov. 158 (5):1032-8. [Medline]. [Full Text].

  31. Korobelnik JF, Holz FG, Roider J, Ogura Y, Simader C, Schmidt-Erfurth U, et al. Intravitreal Aflibercept Injection for Macular Edema Resulting from Central Retinal Vein Occlusion: One-Year Results of the Phase 3 GALILEO Study. Ophthalmology. 2014 Jan. 121 (1):202-8. [Medline]. [Full Text].

  32. Heier JS, Clark WL, Boyer DS, Brown DM, Vitti R, Berliner AJ, et al. Intravitreal aflibercept injection for macular edema due to central retinal vein occlusion: two-year results from the COPERNICUS study. Ophthalmology. 2014 Jul. 121 (7):1414-1420.e1. [Medline]. [Full Text].

  33. Batioglu F, Astam N, Ozmert E. Rapid improvement of retinal and iris neovascularization after a single intravitreal bevacizumab injection in a patient with central retinal vein occlusion and neovascular glaucoma. Int Ophthalmol. 2008 Feb. 28(1):59-61. [Medline].

  34. Kriechbaum K, Michels S, Prager F, et al. Intravitreal Avastin for macular oedema secondary to retinal vein occlusion: a prospective study. Br J Ophthalmol. 2008 Apr. 92(4):518-22. [Medline].

  35. Epstein DL, Algvere PV, von Wendt G, Seregard S, Kvanta A. Benefit from bevacizumab for macular edema in central retinal vein occlusion: twelve-month results of a prospective, randomized study. Ophthalmology. 2012 Dec. 119 (12):2587-91. [Medline].

  36. Central Vein Occlusion Study Group. A randomized clinical trial of early panretinal photocoagulation for ischemic central vein occlusion. The Central Vein Occlusion Study Group N report. Ophthalmology. 1995 Oct. 102(10):1434-44. [Medline].

  37. Central Vein Occlusion Study Group. Central vein occlusion study of photocoagulation therapy. Baseline findings. Online J Curr Clin Trials. 1993 Oct 14. Doc No 95:[Medline].

  38. Central Vein Occlusion Study Group. Evaluation of grid pattern photocoagulation for macular edema in central vein occlusion. The Central Vein Occlusion Study Group M report. Ophthalmology. 1995 Oct. 102(10):1425-33. [Medline].

  39. Browning DJ, Rotberg MH. Vitreous Hemorrhage complicating laser-induced chorioretinal anastomosis for central retinal vein occlusion. Am J Ophthalmol. 1996 Oct. 122(4):588-9. [Medline].

  40. Eccarius SG, Moran MJ, Slingsby JG. Choroidal neovascular membrane after laser-induced chorioretinal anastomosis. Am J Ophthalmol. 1996 Oct. 122(4):590-1. [Medline].

  41. Luttrull JK. Epiretinal membrane and traction retinal detachment complicating laser- induced chorioretinal venous anastomosis. Am J Ophthalmol. 1997 May. 123(5):698-9. [Medline].

  42. McAllister IL, Constable IJ. Laser-induced chorioretinal venous anastomosis for treatment of nonischemic central retinal vein occlusion. Arch Ophthalmol. 1995 Apr. 113(4):456-62. [Medline].

  43. Mirshahi A, Roohipoor R, Lashay A, et al. Surgical induction of chorioretinal venous anastomosis in ischaemic central retinal vein occlusion: a non-randomised controlled clinical trial. Br J Ophthalmol. 2005 Jan. 89(1):64-9. [Medline].

  44. Beck AP, Ryan EA, Lou PL, et al. Controversies regarding radial optic neurotomy for central retinal vein occlusion. Int Ophthalmol Clin. 2005 Fall. 45(4):153-61. [Medline].

  45. Binder S, Aggermann T, Brunner S. Long-term effects of radial optic neurotomy for central retinal vein occlusion consecutive interventional case series. Graefes Arch Clin Exp Ophthalmol. 2007 Oct. 245(10):1447-52. [Medline].

  46. Friberg TR, Smolinski P, Hill S, et al. Biomechanical assessment of radial optic neurotomy. Ophthalmology. 2008 Jan. 115(1):174-80. [Medline].

  47. Opremcak EM, Bruce RA, Lomeo MD, et al. Radial optic neurotomy for central retinal vein occlusion: a retrospective pilot study of 11 consecutive cases. Retina. 2001. 21(5):408-15. [Medline].

  48. Weizer JS, Stinnett SS, Fekrat S. Radial optic neurotomy as treatment for central retinal vein occlusion. Am J Ophthalmol. 2003 Nov. 136(5):814-9. [Medline].

  49. Arevalo JF, Garcia RA, Wu L, et al. Radial optic neurotomy for central retinal vein occlusion: results of the Pan-American Collaborative Retina Study Group (PACORES). Retina. 2008 Oct. 28(8):1044-52. [Medline].

  50. Leizaola-Fernandez C, Suarez-Tata L, Quiroz-Mercado H, et al. Vitrectomy with complete posterior hyaloid removal for ischemic central retinal vein occlusion: series of cases. BMC Ophthalmol. 2005 May 20. 5:10. [Medline].

  51. Cekic O, Chang S, Tseng JJ, et al. Intravitreal triamcinolone treatment for macular edema associated with central retinal vein occlusion and hemiretinal vein occlusion. Retina. 2005 Oct-Nov. 25(7):846-50. [Medline].

  52. Catier A, Tadayoni R, Paques M, et al. Characterization of macular edema from various etiologies by optical coherence tomography. Am J Ophthalmol. 2005 Aug. 140(2):200-6. [Medline].

  53. (unpublished) A randomized, double-masked, sham-controlled phase 3 study of the efficacy, safety and tolerability of repeated intravitreal administration of VEGF trap-eye in subjects with macular edema secondary to central retinal vein occlusion (CRVO) (GALILEO). ClinicalTrials.gov Identifier: NCT01012973.

  54. Bashshur ZF, Ma'luf RN, Allam S, et al. Intravitreal triamcinolone for the management of macular edema due to nonischemic central retinal vein occlusion. Arch Ophthalmol. 2004 Aug. 122(8):1137-40. [Medline].

  55. Ip MS, Gottlieb JL, Kahana A, et al. Intravitreal triamcinolone for the treatment of macular edema associated with central retinal vein occlusion. Arch Ophthalmol. 2004 Aug. 122(8):1131-6. [Medline].

  56. Patel PJ, Zaheer I, Karia N. Intravitreal triamcinolone acetonide for macular oedema owing to retinal vein occlusion. Eye. 2008 Jan. 22(1):60-4. [Medline].

  57. Ramchandran RS, Fekrat S, Stinnett SS, et al. Fluocinolone acetonide sustained drug delivery device for chronic central retinal vein occlusion: 12-month results. Am J Ophthalmol. 2008 Aug. 146(2):285-291. [Medline].

  58. Ferrara DC, Koizumi H, Spaide RF. Early bevacizumab treatment of central retinal vein occlusion. Am J Ophthalmol. 2007 Dec. 144(6):864-71. [Medline].

  59. Epstein DL, Algvere PV, von Wendt G, Seregard S, Kvanta A. Bevacizumab for Macular Edema in Central Retinal Vein Occlusion: A Prospective, Randomized, Double-Masked Clinical Study. Ophthalmology. 2012 Mar 16. [Medline].

  60. Haller JA, et al. Intravitreal aflibercept injection (IAI) for macular edema secondary to branch retinal vein occlusion (BRVO): 24-week, results of the VIBRANT study. Presented at the 38th annual Macula Society meeting. Scottsdale, AZ. February 21, 2014.

Previous
Next
 
Recent onset central retinal vein occlusion, showing extensive hemorrhages in the posterior pole and giving the "blood and thunder appearance."
Peripheral fundus view of the same patient with central retinal vein occlusion as in the previous image, showing hemorrhages extending all over the fundus.
Fluorescein angiograph of same patient with central retinal vein occlusion as in previous images, showing hypofluorescence due to blockage from hemorrhages in the retina. It is not useful to perform a fluorescein angiogram in acute stages of the disease.
Fundus picture of the same patient with central retinal vein occlusion as in previous images, showing resolving neovascularization of the disc and panretinal photocoagulation scars.
Fluorescein angiogram of the same patient with central retinal vein occlusion as in the previous images, taken more than 1 year later, showing persistent cystoid macular edema with good laser spots.
Patient with nonischemic central retinal vein occlusion presented with dilated, tortuous veins and superficial hemorrhages.
Fundus picture of the same patient with central retinal vein occlusion as in previous image, showing resolved hemorrhages and pigmentary changes in the macula several months later.
Central retinal vein occlusion showing significant disc edema with dilated tortuous veins and scattered retinal hemorrhages.
Fluorescein angiogram of the same patient with central retinal vein occlusion in as in previous image, showing leakage from disc, staining of retinal veins.
Fundus of a patient with nonischemic central retinal vein occlusion, showing few scattered peripheral fundus hemorrhages.
Scattered retinal hemorrhages in a patient with central retinal vein occlusion.
Fluorescein angiogram of a patient with nonischemic central retinal vein occlusion, showing staining of dilated tortuous veins with leakage into macula in a cystoid pattern.
Fluorescein angiogram of the same patient as in previous image, showing perifoveal capillary leakage in a cystoid pattern in late phases of angiogram.
Late phase of fluorescein angiograph of the same patient as in previous image, showing cystoid pattern of leakage from perifoveal dilated leaking capillary network.
Arteriovenous phase of fluorescein angiograph showing perifoveal capillary leakage in a patient with nonischemic central retinal vein occlusion.
Fundus picture of a well-compensated, old central retinal vein occlusion showing optociliary shunt vessels.
Red-free photo of the same patient with central retinal vein occlusion as in the previous image, showing prominent optociliary shunt vessels.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.