Retinal vein occlusion: Modern approaches to treatment

Abstract

Retinal vein occlusion (RVO) is the most common retinal vascular disease, it ranks second in terms of severity of retinal damage and prognosis after diabetic retinopathy. The main cause of visual impairment in patients with RVO is the manifestation of macular edema (ME). Persistent ME may block the recovering of visual acuity. The development of new methods of diagnosis and treatment of this pathology has changed approaches to the management of patients with RVO. This review presents the advantages and promising treatment modalities of retinal venous occlusions, it also demonstrates their advantages and disadvantages. Administration of drug treatment in the therapy of RVO is advisable only in the acute period of the disease. Laser coagulation is still the standard treatment for neovascular complications associated with RVO. The necessity of surgical repair remains controversial, since its use can result in severe complications, such as damage to the central retinal artery, perforation of the eye, retinal detachment and traumatic neuropathy. The use of steroids for the treatment of ME is associated with their ability to reduce capillary permeability, however, there is high risk of cataract. Antiangiogenic therapy is effective against pathogenesis of ME in RVO and is a first-line treatment for this disorder. The use of subthreshold microimpulse laser treatment is promising. Possibilities of further improvement and use of combined techniques in the treatment of this pathology are considered.