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Central retinal vein trunk thrombosis
Last reviewed: 07.07.2025
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In thrombosis of the main trunk of the central vein, as well as in thrombosis and embolism of the central artery, vision in the affected eye suddenly decreases. However, complete blindness usually does not occur, vision (albeit low) is preserved. The ophthalmoscopic picture of thrombosis of the central retinal vein is very characteristic. A thrombus in the trunk of the central vein prevents outflow from the entire system of retinal vessels. Numerous hemorrhages of various sizes, round and in the form of streaks, are visible throughout the retina. White limited spots - plasmorrhagia - stand out against the background of hemorrhages. The boundaries of the optic nerve disc are blurred. In thrombosis of a separate, smaller branch of the central retinal vein, a similar ophthalmoscopic picture is noted: vein dilation and hemorrhages, only limited to one quadrant. Retinal vein thrombosis occurs in the elderly. Its causes are general atherosclerosis and arteriosclerosis.
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Treatment of central retinal vein thrombosis
Previously, the prognosis was unfavorable, but now, thanks to the use of anticoagulants (under systematic control of the prothrombin index), cases of improved vision and disappearance of retinal hemorrhages are observed much more often. Under the influence of anticoagulants, the thrombus is canalized. The following are used:
- fibrinolysin (20-40 thousand units intravenously), urokinase (jet), heparin;
- angioprotectors (prodectin, dicynone, complimin, cavinton, trental), venorutal, troxevasin, anti-sclerotic drugs, B vitamins, corticosteroids.
The purpose of laser coagulation is to turn off ischemic zones (burn them) so that there is no stimulation for neovascularization (prevention of secondary uveitis, hemophthalmitis).