Macular Pucker

What is a Retinal Vein Occlusion?
There are two types of Retinal Vein Occlusion (RVO): Branch Retinal Vein Occlusion and Central Retinal Vein Occlusion. 
Arteries and veins carry blood throughout your body, including your eyes. The retina has one main artery and one main vein. When branches of the retinal vein become blocked, it is called a Branch Retinal Vein Occlusion (BRVO). When the main retinal vein becomes blocked, it is called a Central Retinal Vein Occlusion (CRVO).
When the vein is blocked, blood and fluid spills out into the retina. The macula can swell from this fluid, affecting your central vision. Eventually, without blood circulation, nerve cells in the eye can die and you can lose more vision.

Who is at Risk for a Retinal Vein Occlusion?
The following factors increase your risk of RVO:
• 50 years of age or older
• High blood pressure
• Diabetes
• Glaucoma
• Hardening of the arteries (called arteriosclerosis)

To lower your risk for RVO, you should:
• Eat a low-fat diet
• Get regular exercise
• Maintain an ideal weight
• Refrain from smoking

Treatment and Prognosis
BRVO and CRVO cannot be cured. The main goal of treatment is to keep your vision stable. This is usually done by sealing off any leaking blood vessels in the retina. This helps prevent further swelling of the macula.  
It usually takes a few months after treatment before you notice your vision improving. While most people see some improvement in their vision, some people will not have any improvement.
Anti-VEGF Treatment
VEGF, also known as Vascular Endothelial Growth Factor, is a molecule that causes the growth of leaky blood vessels in patients with PDR. Anti-VEGF medications help stop the growth of new blood vessels and the reduce swelling of the macular.

These medications include:
• Bevacizumab (Avastin)
• Ranibizumab (Lucentis)
• Aflibercept (Eylea)

Our retina specialists will inject these medications into the affected eye. Patients may need injections every four weeks to maintain the beneficial effect of the medication. In some instances, patients may partially recover vision as the blood vessels shrink and the fluid under the macula is absorbed.

Focal Laser Treatment
This procedure can stop or slow the leakage of blood and fluid from the blood vessels. This can also keep eye pressure from increasing too much. During the procedure, leaks from abnormal blood vessels are treated with laser burns. Focal laser treatment is usually done in our office in a single session.