WHAT WE TREAT
Branch Retinal Vein Occlusion
BRVO is a blockage in a small retinal vein that causes swelling and vision changes.
About Branch Retinal Vein Occlusion
Overview
The retina is a thin, light-sensitive layer of tissue that lines the back of the eye and connects to the brain through the optic nerve. It functions much like film in a camera — receiving light, converting it into electrical signals, and transmitting those signals to the brain, where they are interpreted as visual images. The central portion of the retina, called the macula, is responsible for sharp, central vision used for reading, driving, and recognizing faces.
BRVO typically occurs in individuals over age 50, though it can develop in younger patients. It affects men and women equally and may lead to vision loss and other retinal complications if left untreated.
Causes
For the retina to function properly, it requires a constant supply of blood and oxygen through a network of arteries and veins. When one of the small retinal veins becomes blocked, blood flow is interrupted. This blockage is called a Branch Retinal Vein Occlusion (BRVO).
Treatment Options From LRR
Treatments
While BRVO cannot be cured, early diagnosis and management can significantly improve outcomes. Treatment focuses on reducing macular swelling, preventing abnormal vessel growth, and addressing underlying systemic conditions.
Treatment typically involves pan-retinal photocoagulation (PRP)—a laser procedure that targets the peripheral retina to reduce oxygen demand and halt abnormal vessel growth. If bleeding does not clear spontaneously, a vitrectomy surgery may be necessary to remove the blood and vitreous gel. In severe cases, surgical repair may also be required for retinal detachment.
More To Know
Risk Factors
Managing risk factors is an important part of both prevention and treatment.
Several medical and lifestyle factors increase the likelihood of developing BRVO, including:
- High blood pressure (hypertension)
- Atherosclerosis (hardening of the arteries)
- High cholesterol or lipid levels
- Smoking
- Heart or vascular disease
- Blood-clotting disorders
- Glaucoma
- History of stroke
- Inflammatory or infectious diseases
Symptoms
In BRVO, blood and fluid leak into the retina, causing blurred or distorted vision. In many cases, the blood and fluid gradually reabsorb, but this may take several months. The degree of visual change depends on the location and extent of the blockage.
Common symptoms include:
- Blurred or distorted central or peripheral vision
- Areas of vision loss
- Floaters or hazy spots
- Occasionally, no noticeable symptoms in early stages
Medical and Preventive Care
Your doctor will first identify and manage systemic risk factors such as hypertension, diabetes, and cholesterol.
- Blood pressure control
- Smoking cessation
- Cholesterol and blood-sugar management
- Aspirin or other blood-thinning therapy (when appropriate, under guidance from your primary care provider)
Intravitreal Injections
Medications known as anti-VEGF agents are commonly used to reduce retinal swelling and prevent abnormal vessel growth. In some cases, steroid injections (such as Ozurdex® or Triesence®) may be used to reduce inflammation and edema. Because steroids can raise eye pressure, patients are monitored closely, especially those with glaucoma.
These medications are injected directly into the eye and include
- Aflibercept (Eylea®)
- Vabysmo (Faricimab®)
- Ranibizumab (Lucentis®)
- Bevacizumab (Avastin®) – This is a cancer medication not FDA approved for use in the eye. It is used off-label in some situations.
Diagnosing BRVO
Your retina specialist may use one or more specialized imaging tests to confirm and assess the severity of a BRVO:
- Fluorescein angiography (FA): A dye-based imaging test that highlights retinal blood vessels
- Optical Coherence Tomography (OCT): High-resolution imaging that shows retinal swelling and fluid
- Color fundus photography: Detailed color photographs of the retina to document hemorrhages and vessel changes
Potential Complications
If untreated, BRVO can lead to several complications that threaten vision:
- Macular edema: Swelling and fluid accumulation in the macula
- Macular ischemia: Reduced blood flow to the macula
- Neovascularization: Growth of abnormal new blood vessels that may bleed or cause scarring
Potential Complications
In some cases, BRVO can lead to retinal neovascularization, where fragile new blood vessels grow into the vitreous cavity. These vessels can rupture, causing:
- Vitreous hemorrhage (bleeding inside the eye)
- Scar tissue formation
- Tractional retinal detachment
Laser Treatment
Focal or grid laser photocoagulation may be performed to reduce macular edema and stabilize vision. The landmark Branch Vein Occlusion Study demonstrated that laser therapy can improve visual outcomes in many patients over time. Multiple sessions may be required for optimal results.
Prepare For Your Visit
If you already have an appointment made, we look forward to providing your care! If you need an appointment or have questions, please reach out to the Lakes Region Retina care team.
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