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Vascular Occlusive Disease

  • Chapter
Retinal Vascular Disease

Abstract

A complicated well-regulated balance exists between the thrombosis and fibrinolysis systems. This chapter will cover the two main categories of retinal vascular occlusive disease (RVOD): central (CVO) or branch retinal vein occlusion (BVO) and central (CAO) or branch retinal artery occlusion (BAO). This chapter will not address the overall diagnostic evaluation of patients with retinal vascular disease. Patients with CAO/BAO should be evaluated by their medical doctor for common underlying causes such as ipsilateral carotid disease and heart disease. Patients with bilateral, simultaneous CVO/BVO of course should be evaluated for common causes of hypercoagulable states such as Waldenström’s or multiple myeloma. Basic evaluation should include a medical review of systems, testing for high blood pressure and diabetes for all patients, and sedimentation rate, carotid Doppler and cardiac sonogram should always be obtained for retinal arterial disease (RAO). After a basic evaluation, many patients with RAO or retinal venous disease (RVO) are said to have idiopathic conditions. In recent years, there have been a large number of papers citing possible associations of RAO and RVO with abnormalities of plasma proteins. Are these associations real? Which should be considered and looked for in which patients? It will be some years before we can offer clear guidance on this subject, and there is a strong need for large prospective studies with contemporaneous well-matched control groups. Until these studies are available, in this chapter we summarize the pertinent literature and offer some thoughts on whether and how patients with RAO and RVO who do not have obvious causes after a “basic” evaluation should be worked up.

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Authors and Affiliations

  1. Department of Ophthalmology, The Wilmer Eye Institute, Johns Hopkins University, 600 N. Wolfe Street, Baltimore, MD, 21287, USA

    Eric Tourville MD

  2. The Cole Eye Institute, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio, 44195, USA

    Andrew P. Schachat MD

  3. Department of Ophthalmology, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany

    Lutz L. Hansen MD

  4. Department of Ophthalmology, University of Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany

    Hans Hoerauf MD

  5. International Centre for Eye Health, Department of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK

    Matthew Burton MA, PhD, MRCP, MRCOphth

  6. Moorfields Eye Hospital, City Road, London, EC1V 2PD, UK

    Zdenek Gregor FRCS, FRCOphth

  7. Retina Service, Wills Eye Hospital, Jefferson Medical College, 840 Walnut Street, Philadelphia, PA, 19107, USA

    Gary C. Brown MD, MBA

  8. Center for Value-Based Medicine, Box 355, Flourtown, PA, 19031, USA

    Gary C. Brown MD, MBA & Melissa M. Brown MD, MN, MBA

  9. Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA

    Melissa M. Brown MD, MN, MBA

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Editors and Affiliations

  1. Department of Ophthalmology, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany

    Antonia M. Joussen MD, PhD (Professor of Ophthalmology) (Professor of Ophthalmology)

  2. Department of Ophthalmology, Penn State College of Medicine, 500 University, Drive Box 850, Hershey, PA, 17033, USA

    Thomas W. Gardner MD, MS (Professor of Ophthalmology) (Professor of Ophthalmology)

  3. Department of Vitreoretinal Surgery, Center for Ophthalmology, University of Cologne, Joseph-Stelzmann-Straße 9, 50931, Cologne, Germany

    Bernd Kirchhof MD (Professor of Ophthalmology) (Professor of Ophthalmology)

  4. Doheny Eye Institute, University of Southern California, 1450 San Pablo Street, Los Angeles, CA, 90033, USA

    Stephen J. Ryan MD (Professor of Ophthalmology) (Professor of Ophthalmology)

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Tourville, E. et al. (2007). Vascular Occlusive Disease. In: Joussen, A.M., Gardner, T.W., Kirchhof, B., Ryan, S.J. (eds) Retinal Vascular Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-29542-6_21

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