Criteria

RVO is usually classified by the location of the occlusion.[4]​ Examination and investigation findings vary by location of occlusion as follows:

Central retinal vein occlusion (CRVO):

  • Four quadrants of retinal haemorrhages, vascular tortuosity and dilation, and retinal thickening

  • Optic nerve head oedema

  • Delayed central retinal venous filling on fluorescein angiogram.

Branch retinal vein occlusion (BRVO):

  • One quadrant of retinal haemorrhage, vascular tortuosity and dilation, and retinal thickening

  • Delayed branch retinal venous filling on fluorescein angiogram.

Hemiretinal vein occlusion (HRVO):

  • Retinal haemorrhages, vascular tortuosity and dilation, and retinal thickening limited to superior or inferior retinal hemisphere

  • Optic nerve head oedema may be present

  • Delayed filling of superonasal and superotemporal or inferonasal and inferotemporal retinal veins on fluorescein angiogram.

Ischaemic/non-perfused versus non-ischaemic/perfused RVO

Ischaemic CRVO is associated with:​​ the presence of ≥10 disk areas of non-perfusion on 7-field fluorescein angiography and usually ≥1 of the following:[26]

  • Poor visual acuity (<6/60)

  • Relative afferent pupillary defect

  • Multiple dark deep intraretinal haemorrhages

  • Multiple cotton wool spots

  • Retinal vein tortuosity and dilation

  • Reduced b-wave amplitude, reduced b:a ratio and prolonged b-wave implicit time on electroretinogram.

In BRVO the degree of non-perfusion is important to guide treatment and prognosis:[4]

  • Non-perfused: presence of ≥5 disk areas of non-perfusion as assessed by fluorescein angiography.

  • Perfused: presence of <5 disk areas of non-perfusion.

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