What Is a Vascular Occlusion?

Retinal vascular occlusion is a blockage of retinal arteries or veins that causes a high degree of retinal anemia or bleeding. Mostly caused by vasospasm or emboli (thrombus) blocking the lumen, mainly related to arteriosclerosis and hypertension. Sudden and severe vision loss is characteristic of this disease.

Basic Information

Visiting department

Ophthalmology

Common causes

Systemic diseases such as hypertension, hyperlipidemia, diabetes, etc.

Common symptoms

Sudden visual impairment, vision loss, dark shadows, etc.

Contagious

no

Causes of retinal vascular obstruction

1. Systemic diseases such as hypertension, hyperlipidemia, diabetes, and arteriosclerosis cause narrowing and hardening of blood vessels, which are related to retinal vascular occlusion.
2. Thrombosis, vascular inflammation, changes in blood composition, and changes in blood flow state can all lead to retinal vascular occlusion.
3. Oral contraceptives, excessive fatigue, elevated intraocular pressure, emotional excitement, etc. are the causes of this disease.

Clinical manifestations of retinal vascular occlusion

1. Short-term visual impairment or extreme vision loss is a characteristic of the disease.
2. The part in front of the eyes is blocked and there are fixed black shadows.
3. Some patients have aura symptoms, such as painless transient blindness.

Retinal vascular obstruction

Ophthalmoscope and fundus fluorescein angiography.

Diagnosis of retinal vascular occlusion

1. Retinal artery occlusion (1) The symptoms of patients and the history of systemic diseases are helpful for diagnosis.
(2) Ophthalmoscope: The edge of the optic nipple is blurred, the color is pale, and the atrophy becomes white in the late stage; the retina near the optic nipple is anemia, the posterior pole is milky white turbid edema, and the macula is cherry red; The shape, blood column may be segment-like or rosary-like, and the distal end disappears. The veins became thin and dark red.
(3) Fundus fluorescein angiography: delayed or no perfusion of retinal arterial fluorescence.
2. Retinal vein occlusion (1) The symptoms of patients and the history of systemic diseases are helpful for diagnosis.
(2) Ophthalmoscope: Optic papillary edema, blurred borders, bleeding spots on the surface, and neovascularization in late stages. When the central vein is blocked, the nipple is the center of the superficial hemorrhage, and the peripheral omentum may enter the vitreous for a long time, causing different degrees of vitreous opacity. When the branch vein is blocked, the bleeding is distributed only along the involved veins, and the omentum in the posterior pole is edema. The veins dilate and appear dark red. Late bleeding exudates and absorbs, collateral circulation is formed, and retina, optic papilla, atrial angle, and iris neovascularization can occur.
(3) Fundus fluorescein angiography: delayed and incomplete venous perfusion, and fluorescent shielding of bleeding areas. Late collateral circulation and neovascularization. Vein wall staining, cystoid edema may appear in the macula.

Retinal vascular occlusion treatment

Central retinal artery occlusion should be treated as an emergency.
1. Etiology treatment Actively treat vascular diseases such as atherosclerosis, hypertension, hyperlipidemia, diabetes and other causative factors.
2. Drug therapy Application of vasodilator drugs, such as inhalation of isoamyl nitrite or nitroglycerin under the tongue.
3. Intermittently massage the eyeball with your finger for 10-15 seconds and then abruptly withdraw, and then repeatedly press to promote recanalization of blood vessels.
4. To prevent thrombosis from forming again, use anticoagulants, and apply traditional Chinese medicine to promote blood circulation and dissipate blood stasis.
5. Oxygen inhalation: 95% oxygen and 5% carbon dioxide mixed gas, once an hour for 10 minutes each time.
6. Laser treatment helps prevent or block the growth of new blood vessels. Fundus fluorescein angiography confirmed significant retinal ischemia. Can do full retinal photocoagulation or partial retinal photocoagulation. It should be reviewed regularly after treatment, and photocoagulation should be supplemented according to specific conditions.
7. Early hyperbaric oxygen therapy.