Walsh & Hoyt: Central Retinal Vein Occlusion

Central retinal vein occlusion (CRVO) is a common ocular disorder with a prevalence of 1% overall and 4% in individuals over age 49. Most patients who develop this condition are over 50 years old, and 5075% have associated hypertension, diabetes mellitus, renal disease, and/or hyperlipidemia. There is a strong association between CRVO and atherosclerotic disease of the central retinal artery. Atherosclerosis of the central retinal artery within the optic nerve, where it is adjacent to, and shares a common sheath with, the central retinal vein, presumably causes compression and irritative endothelial proliferation within the central retinal vein. Color Doppler imaging has demonstrated high vascular resistance in the central retinal artery, ophthalmic artery, and short posterior ciliary arteries of both affected and fellow eyes, suggesting that diffuse small-vessel disease may predate and contribute to the development of CRVO in some cases. Additional less common mechanisms for CRVO include mechanical compression, inflammation, or other abnormalities of vessel wall, and a variety of hypercoagulable states.