Branch Retinal Vein Occlusion (BRVO) – How Serious Is It?

Medically reviewed by Sharon Copeland on 08 June 2022

The retina is the thin membrane at the back of the eye. Branch Retinal Vein Occlusion (BRVO) occurs when a blockage occurs in one of the veins in the retina. This blockage drains blood out of the eye and causes blood and other fluids to leak into the retina, this can cause swelling, bruising and a lack of oxygen, which can cause reduced vision.

This condition is most common in 60-70 year olds, it’s less common in those under 40, although it can affect anyone.

What is Branch retinal vein occlusion?

Branch Retinal Vein Occlusion is when a blood clot forms a blockage or obstruction of one (or several) of the branches of the retinal vein. An obstruction in the retina’s central retinal vein is called a central retinal vein occlusion (CRVO), whereas an obstruction in a smaller vein is called a branch retinal vein occlusion (BRVO).

Central retinal vein is more severe as this causes vision loss.

Branch Retinal Vein Occlusion symptoms include:

• Loss of peripheral vision
• Blurred central vision
• Floaters

Can BRVO cause blindness?

When the retinal vein carrying blood is blocked, this limits the amount of blood that can be carried through the eye, which can cause a build-up of fluid, resulting in loss of vision quality. The swelling caused by BRVO, also known as a macular oedema, which if not treated, can lead to vision loss or even blindness.

Neovascularization: Retinal Vein Occlusion (RVO) can cause the retina to develop new, abnormal blood vessels, a condition called neovascularization. These new vessels may leak blood or fluid into the vitreous that fills the inside of the eye. Small spots or clouds, called floaters, may appear in the field of vision. With severe neovascularization, the retina may detach from the back of the eye.

Neovascular glaucoma: new blood vessels in certain parts of the eye can cause pain and a dangerous increase in pressure inside the eye.

The complications of RVO, especially if they are not treated, can lead to irreversible loss of vision.

What causes BRVO?

BRVO occurs when the blood flow is blocked within a vein in the eye. The conditions listed are all risk factors for developing this condition:

• Smoking
• High cholesterol
• Glaucoma
• Diabetes
• High blood pressure
• Some blood disorders
• History of myocardial infarction or stroke
• Blood coagulation disorders
• Systemic vascular inflammatory disorders

Some will not have any of these contributing risk factors but will still develop the condition. Maintaining a healthy and balanced lifestyle is still important to help reduce your risk where possible.

Can retinal vein occlusion be reversed?

Retinal vein occlusion cannot be reversed, but treatment has the potential to improve visual acuity. Treatment options that can maintain/improve vision include:

• Laser treatment (though this method has been proven ineffective for patients with central retinal vein occlusions)
• Intravitreal injections of anti-VEGF drugs
• Steroid implant

Digital image tests are usually performed on the retina to assess the blood circulation within the eye. One of these tests is called Fluorescein angiography, which involves injecting dye into the hand or arm. As the dye travels through the blood vessels, a camera can then look at blood flow in the retina and choroid.

Digital image tests (optical coherence tomography oct) are usually performed on the retina to assess the blood circulation within the eye. Those with retinal vein occlusion will have these tests done regularly to help monitor the condition; these tests can also help to determine which treatment is the most suitable.

Ophthalmoscopy may also be done (examining the back of the eye). The changes caused by RVO may be seen by examination of the retina with an instrument called an ophthalmoscope.