Central Retinal Vein Occlusion (CRVO) with Macular Edema Treatment in Tampa, FL

The eye works like a camera. It has two parts, a lens and a film. The film layer lines the back wall of the eyes and is called the retina. It has arteries that provide it blood flow and veins which drain the blood. The arteries and the veins share a common tubing. Over time, the arteries can become hardened and push firmly on the veins. If too much force is applied, it can cause a blockage of a retinal vein.

The part of the retina that is responsible for the central vision is called the macula. A blockage of a retinal vein may cause an accumulation of fluid within the macula called macular edema. The reason why this occurs is due to lack of blood flow to the retina. The retina recognizes the lack of blood flow to the retina and creates a hormone that encourages swelling within the retina.

CRVO with Macular Edema Treatment Options

The most effective treatment for this condition is a medication which is injected into the eye that blocks the undesirable hormone produced by the retina. Blocking the hormone causes the swelling to decrease, and eventually resolve.

The procedure of injecting the medication is called an intravitreal injection.

The injection is typically performed monthly for a period of 6 months. Most patients notice a substantial improvement within the first 4 months of treatment followed by a slower improvement by 6 months after the first injection. 

After a period of 6 months, the frequency of injections may be slowly decreased or injections may potentially stop completely. If injections are stopped completely, your eye care specialist will typically monitor your eye for signs of the macular edema returning.

There are some patients who need only a few injections during their entire treatment and others who go on to need treatment every 4 weeks for years. Your eye care specialist is not able to know how many injections you will need. Your eye care specialist will customize your treatment to the needs of your eye.

The main risk of the procedure is the development of an infection called endophthalmitis. Fortunately, the risk of this infection is very low, occurring in approximately 1 in 3000 injections. Patients can decrease their risk of developing an infection by avoiding rubbing, touching their eyes, or allowing water into their eyes for at least one week.

Most patients undergoing this treatment note a significant improvement in their vision and are surprised that the injection may be administered with minimal discomfort.

Causes

Now, let’s talk about why this condition occurs and how patients may decrease the risk of a central retinal vein occlusion in the other eye.

This condition occurs due to a hardening of the arteries. Hardening of the arteries is caused by a combination of age, high blood pressure, diabetes, and or high cholesterol. Patients who do not have these diagnoses are asked to be tested by their primary care doctor. It is important that these conditions are well controlled, if present. This decreases the risk of the retinal vein occlusion becoming worse or occurring in the other eye.

There are a number of uncommon causes of this condition that make up an extremely small percentage of central retinal vein occlusions. Your eye care specialist will order a special blood test for you if they think this may be the cause.

What should patients watch out for?

The new onset of worsening blurry vision may be a sign of swelling in the macula. We ask patients to contact their eye care specialist if they note worsening vision as this may be a sign that treatment is needed.

The new onset of many floaters may be a sign of a small amount of bleeding in the eye which may also require an evaluation and treatment prior to the next scheduled visit.

Severe persistent eye pain and headache may be a sign of increased eye pressure requiring evaluation and treatment promptly.

Why is it important to follow-up with your eye care specialist?

Untreated swelling in the macula can cause permanent vision loss if present for weeks to months without treatment.

Abnormal new blood vessels can form which may bleed and temporarily decrease vision. Your eye care specialist may be able to detect these in the early stage and initiate treatment to decrease the risk of vision loss.

Treatment at the correct duration helps to maximize vision.