What is it?
Venous or arterialocclusions
Venous or arterial occlusions are total or partial obstructions of the retinal blood vessels that hinder blood flow through them. Depending on the location of these obstructions, two types can be differentiated: occlusions in the central vein and occlusions in the branch vein, which is the area where arteries and veins cross.
In the case of venous occlusions, the venous return is interrupted and the retinal area becomes flooded. This type of obstruction is usually due to the presence of a thrombus, so any disease that favors thrombus formation may contribute to this ocular pathology.
In the case of arterial occlusions, the main consequence is the lack of blood supply to the retinal tissue, which no longer receives an adequate supply of nutrients, especially oxygen, which can lead to infarction (ischemia). It is important to bear in mind that sometimes the arterial obstruction is caused by a thrombus coming from another part of the body.
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Diabetes, hypertension, cholesterol and tobaccoconsumption, as well as cardiovascular diseases that favor thrombus formation, constitute the main risk factors for these cardiovascular accidents.
Retinal venous occlusion represents the most frequent vascular condition causing vision loss after diabetic retinopathy. It occurs in adulthood and usually affects men and women equally.
SYMPTOMS
Venous and arterial obstructions in the retina cause a sudden and painless visual decrease or loss. Depending on the area of the retina where they are located, this pathology may be asymptomatic for the patient. The degree of visual impairment will depend on whether it is a venous or arterial occlusion. In the latter case, obstructions cause an infarction of the tissue and, therefore, an irreversible loss. Another determining factor is the caliber of the obstructed vessel. The visual alteration that the patient may suffer differs notably when the obstruction is located in the central vein or in a peripheral vessel.
Finally, if the central area of the retina (the macula) is involved in this vascular complication, the visual loss will be even greater, even if it is a mild arterial or venous occlusion. Although this symptomatology is almost imperceptible in a very early stage, in a short period of time it may become more severe and irreversible. For this reason, it is essential to identify and manage possible complications as soon as possible.
The appearance of these symptoms should lead the patient to make an appointment with the retina specialist as soon as possible. A complete examination will allow you to diagnose whether there is an artery or vein obstruction, assess the extent of retinal damage and determine the treatment to be followed.
Treatment
In the case of venous occlusions, the body itself acts by creating collateral vessels to drain the blood that cannot flow normally through the obstructed vessel. While these vessels are being formed, retinal swelling (edema) must be controlled.
To this end, pharmacological advances such as intravitreal injections of antiangiogenic drugs or steroid medication help to keep the retina dry and thus improve the patient’s visual prognosis.
If these neoformations are adequate, the inflammation may disappear on its own. When necessary, this treatment should be complemented with laser photocoagulation in the affected retinal areas. This therapeutic option also helps to prevent those retinal complications that seriously threaten vision.
In arterial occlusions there is no effective treatment, especially if it is a permanent obstruction. Normally, this type of case is more serious because it produces an infarction of the tissue, especially if it affects the central retinal area. In some extreme cases, surgical intervention will be necessary.
Only if the arterial obstruction is caused by inflammation of the vessel, treatment with anti-inflammatory drugs is indicated.
It should be remembered that prolonged delay in treatment may result in irreversible loss of central vision.
Other pathologies
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