Central vein occlusion: what therapies?

Among its causes, atherosclerosis occupies a prominent role. Less certain, however, is the most suitable treatment. Here are the proposed methods to cope with this eye problem

Atherosclerosis, hypertension and diabetes also endanger eye health, which can lead to serious problems such as occlusion of retinal veins.

Particularly frequent is the occlusion of the central vein – the vessel that collects blood from the capillaries of the retina and directs it to the outside of the eye – a problem that from a clinical point of view manifests itself with a more or less serious loss of vision associated with hemorrhages and macular edema.

In fact, the main cause of vision loss associated with central vein occlusion is macular edema. The blockage of blood flow leads to its stagnation in the retina, resulting in damage to its tissues.

The hypothesis is that an increase in the production of a protein, vascular endothelial growth factor (VEGF), comes into play, which in addition to stimulating the production of new blood vessels would also lead to the weakening of the capillary walls, with consequent leakage of fluids, edema formation and vision loss.

Targeted action against the person directly responsible

It is no coincidence that among the therapies proposed to cope with the complications of central vein occlusion, the treatments directed against VEGF stand out.

The active substances used include corticosteroids. Systems implanted inside the eye allow, for example, the gradual release of dexamethasone, which can thus be administered continuously for a few months, during which the risk of further loss of vision decreases and it is also possible to recover part of the visual acuity already lost.

Alternatively, corticosteroids can be injected directly into the vitreous (the gelatinous mass that fills the eye), where they would act precisely by reducing VEGF concentrations and, consequently, capillary permeability and macular edema.

Intravitreal injection is the method of administration chosen even if the therapy against central vein occlusion is based on an anti-VEGF drug. Ranibizumab and aflibercept have been successfully used to treat macular edema, demonstrating their effectiveness in both reducing edema and improving vision.

Also in their case the mechanism of action involves a lowering of VEGF levels that leads to the reduction of capillary permeability and edema.

Not only drugs

In addition to pharmacological therapies, laser photocoagulation can also be useful in case of occlusion of the central vein. At the moment, however, there are no definitive guidelines on its use. Surgery also offers other solutions.

Only an experienced doctor will be able to suggest the most suitable approach among those available today. Whatever solution is proposed, those dealing with a central vein occlusion should not forget the importance of regular monitoring of the situation and regular vision checks.

Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.

The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.

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