All the retinal blood circulation leaves the eye through your central retinal vein. This central vein is now blocked – we call this a central retinal vein occlusion (CRVO). This causes stagnant circulation and retinal haemorrhages along the tributaries of every single retinal vein. Swelling, and poor oxygenation of the retina ensue.
CRVO is a very, very serious eye condition. Despite modern technology, CRVO’s can cause permanent blindness.
Central vein occlusions are graded along a spectrum of severity from less severe (non-ischemic CRVO) to blinding (ischemic CRVO). *Unfortunately, one third of non-ischemic CRVOs become ischemic. 25% of ischemic CRVO eyes develop painful glaucoma.
Until recently, no treatment was available to improve the vision of an eye with CRVO.
However, the prognosis of a CRVO has improved significantly in the last 5 years. To preserve your vision and prevent blindness, it is important to initiate treatment as soon as possible.
We now have a medication that can dramatically improve the vision of patients with non-ischemic CRVOs. Currently in Australia, eye-doctors treat CRVOswith an eye-injection of a medication called Avastin, which is an Antibody against Vascular Endothelial Growth Factor (Anti-VEGF).
Avastin is very safe and complications are rare. Eye-injections are fortunately very well-tolerated by most patients.
CRVO is a highly variable disease. It is difficult to predict the final outcome of an eye with CRVO.
Most patients require treatment for at least 6 months. The injections are given every 4weeks. I monitor your progress by checking vision, examining your eyes and analysing your OCT images.
If you have a very good response to treatment, I will stop the injections and monitor you for a relapse. It is common to see relapses, which are then retreated with Avastin injections.
**In these eyes, I will try up to 6 months of treatment. If there is no prospect of visual recovery, I may have to treat the eye with laser burns to prevent the development of painful glaucoma.
Every eye is different – I believe that it is important to individualize treatment to your needs and your eye.
The cost of Avastin is under $50. My professional fees for performing an injection will cost you $100 out of pocket. This covers the consultation and any additional tests such as OCT imaging (unlike other eye doctors, I do not charge for OCT imaging in my practice).
Medicare provides an additional safety-net for patients with high-out-of pocket costs.
This information sheet is an attempt to summarize a complex and evolving management of a highly variable condition. It is not an exhaustive document and it is normal for you to have questions. I encourage you to ask questions at each of your appointments.