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Retinal Vein Occlusion: A Complete Overview from Natural Eye Care

retinal vein occlusionRetinal Vein Occlusion is the blockage of veins that drain blood from the retina in the eye. The eye circulatory system depends on releasing blood back to the heart after it has nourished the retina. When the vein is blocked, hemorrhaging occurs, damaging the retina. It is typically caused by atherosclerosis, a common condition especially in older people that damages the arteries. “Occlusion” means the blockage or closing of a blood vessel.

Symptoms and How Retinal Vein Occlusion Is Diagnosed

A sudden change in vision may indicate retinal vein occlusion.

  • A blurred or missing area of vision is the most common, indicating a branch vein occlusion
  • Less commonly, there is a severe loss of central vision, associated with a central vein becoming blocked.

Any sudden vision changes should be reported to a doctor immediately. The doctor may be able to begin immediate treatment to minimize damage. Waiting in hopes that it will get better on its own is a fallacy. There are immediate treatments available to reduce swelling and fluid leaks, improving the odds of a better recovery.

The doctor, optometrist or ophthalmologist may run these tests:1

  • Dilated eye exam
  • Pupil reflex response
  • Fluorescein angiography
  • Intraocular pressure
  • Slit lamp examination
  • Refraction
  • Retinal photography
  • Visual acuity
  • Testing of side vision (visual field examination)

Additionally, the doctor may check blood cholesterol and triglyceride levels, and test for diabetes. For patients under age 40 (papillophlebitis), an examination of blood clotting and thickening may be conducted.

Causes

Most of the time, retinal vein occlusion is caused by atherosclerosis, also called hardening of the arteries. If central vision is damaged, it is because a blood clot has formed and blocked the vein (CRVO). The more common branch vein occlusion (BRVO) is a blockage of smaller veins in the retina, in places where hardened retinal arteries cross over, putting pressure on a retinal vein. This results in internal bleeding (hemorrhaging) of the retina because the blood cannot drain through its normal routes.

Atherosclerosis is the build-up of plaque inside the arteries.2 Plaque is made from cholesterol, fat and other blood substances. Gradually, plaque hardens and narrows the arteries, limiting blood flow. Less oxygen reaches the tissues, causing damage. It can affect any part of the body, leading to chronic kidney disease, peripheral artery disease (pain or numbness in legs, arms, and pelvis), carotid artery disease (the sides of the neck, leading to stroke) and coronary heart disease.

Atherosclerosis can be symptomless until a major event occurs, such as a heart attack or stroke. A doctor can detect this disease based on your medical history, family histories, physical exam, and results of tests.

Risk factors for atherosclerosis include lack of exercise, smoking, and poor diet. Age and family history are also risk factors. Things to avoid:3

  • Unhealthy blood cholesterol levels
  • High blood pressure (hypertension)
  • Smoking
  • Insulin resistance (from excess body mass)
  • Diabetes (usually Type II, from excess weight)
  • An unhealthy Body Mass Index (overweight or obese)
  • Lack of exercise
  • Poor diet. Avoid saturated fats, trans fats, cholesterol, salt, and sugar
  • Stress
  • Untreated sleep apnea
  • Heavy consumption of alcohol

These are risk factors that you cannot control, but need to consider:

  • Age (increases after age 45 in men, and after age 55 in women)
  • A family history of early heart disease (genetics).

In addition to the risk factors listed above, having another eye disease such as glaucoma, macular edema, or vitreous hemorrhage increase risk of retinal vein occlusion.4

Since these risk factors increase with age, retinal vein occlusion occurs mostly in older people.

Prognosis

Most of the time, vision returns, but it is often damaged. The blockage cannot be opened or reversed. Various eye treatments are available to help repair some of the damage (below).

To prevent another incident and protect the other eye, it is crucial to address the root cause (primarily atherosclerosis), and underlying health issues such as diabetes, high blood pressure and/or high cholesterol for example. Get a complete screening, see the doctor regularly, take any prescribed medications (such as blood thinners, diabetes drugs, statin drugs and blood pressure medication) and follow instructions for lifestyle changes.

Retinal vein occlusion can lead to glaucoma, a serious and insidious disease that damages the optic nerve. New blood vessels can form in the following months and years. These new blood vessels are weak and often leak causing further complications.

Anyone who has had retinal bleeding has an increased risk for retinal detachment. Symptoms include sudden light flashes, sudden appearance of floaters, and vision loss.

Standard Treatment

In addition to following medical instructions for controlling the underlying condition (hardening of the arteries), the doctor may offer these treatments for retinal vein occlusion complications:

  • If Macular Edema is present, focal laser treatment
  • Laser treatment, to help stop the growth of new, abnormal blood vessels. These blood vessels can lead to glaucoma
  • Injecting anti-vascular endothelial growth factor (anti-VEGF) drugs in the eye. They are designed to block the growth of new blood vessels, in an attempt to head off glaucoma

Other Approaches to Retinal Vein Occlusion Support and Prevention

Preventing atherosclerosis, and controlling if it sets in are crucial to preventing having a retinal vein occlusion. Some points:

  • Don’t smoke
  • Work with your doctor to minimize the number of prescription medications
  • Exercise for at least 20 minutes a day
  • Adopt a healthy diet with lean protein sources and plenty of fresh fruits, brightly colored vegetables, and green vegetables (Mediterranean Diet is an excellent one to follow).
  • Maintain a healthy weight

Nutritional support for patients, and those at risk include:

Next: Find Out How the Retinal Circulatory System Works.   Nutrients to Support Eye Vascular Health

  1. U.S. National Library of Medicine – Medline Plus. Retinal Vein Occlusion  https://www.nlm.nih.gov/medlineplus/ency/article/007330.htm
  2. National Institute of Health – National Heart, Lung and Blood Institute https://www.nhlbi.nih.gov/health/health-topics/topics/atherosclerosis
  3. National Institute of Health – National Heart, Lung and Blood Institute https://www.nhlbi.nih.gov/health/health-topics/topics/atherosclerosis/atrisk
  4. U.S. National Library of Medicine – Medline Plus. Retinal Vein Occlusion https://www.nlm.nih.gov/medlineplus/ency/article/007330.htm
  5. “Lutein, Zeaxanthin, and meso-Zeaxanthin in the Clinical Management of Eye Disease” by Scripsema, N.K. et. al. J Ophthalmol. 2015; 2015: 865179. Published online 2015 Dec 24. doi:  10.1155/2015/865179 PMCID: PMC4706936
  6. J Ophthalmol. 2015;2015:687173. doi: 10.1155/2015/687173. Epub 2015 Dec 20. “The Photobiology of Lutein and Zeaxanthin in the Eye.” Roberts J, Dennison J
  7. Zhonghua Yan Ke Za Zhi. 2011 Sep;47(9):824-8. “The protective effects of ginkgo biloba extract on cultured human retinal ganglion cells” Wang YS et. al.
  8. Cell Biochem Biophys. 2011 Sep;61(1):169-77. doi: 10.1007/s12013-011-9173-9. “FTIR assessment of the effect of Ginkgo biloba leaf extract (EGb 761) on mammalian retina.” Gamal EM et. al.
  9. Invest Ophthalmol Vis Sci. 2016 Mar 1;57(3):1361-9. doi: 10.1167/iovs.15-18596. “Elevated Fundus Autofluorescence in Monkeys Deficient in Lutein, Zeaxanthin, and Omega-3 Fatty Acids.” McGill TJ et. al
  10. Mol Nutr Food Res. 2009 Jul;53(7):869-77. doi: 10.1002/mnfr.200800394. “Bilberry and its main constituents have neuroprotective effects against retinal neuronal damage in vitro and in vivo.” Matsunaga N1, Imai S, Inokuchi Y, Shimazawa M, Yokota S, Araki Y, Hara H.
  11. Evid Based Complement Alternat Med. 2010 Mar;7(1):47-56. doi: 10.1093/ecam/nem151. Epub 2007 Oct 27. “Vaccinium myrtillus (Bilberry) Extracts Reduce Angiogenesis In Vitro and In Vivo.” Matsunaga N et al.