Monitoring
Patients with ischaemic central retinal vein occlusion (CRVO) or ischaemic branch retinal vein occlusion (BRVO) should be monitored monthly for the first 6 months for the development of neovascularisation, pupillary assessment for a relative afferent pupillary defect, measurement of intraocular pressure, stereoscopic examination of posterior pole after dilation, optical coherence tomography laboratory when appropriate, and peripheral retina and vitreous examination when indicated.[4][24] They should then be re-examined every 3 months for 6 months, and then every 6 months. Gonioscopy should be performed when intra-ocular pressure is elevated to rule out neovascularisation of the angle.
In patients with CRVO, delaying treatment with vascular endothelial growth factor (VEGF) inhibitors for up to 6 months has been shown to lead to reduced visual improvements compared to the immediate initiation of treatment. Therefore, treatment with VEGF-inhibitors should usually be started as soon as the diagnosis of CRVO is made and only deferred if a joint decision is made for a particular individual.[3]
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