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\_thrombosis.pdf)


**9** 

*Australia* 

**Venous Thrombosis and the Eye** 

Venous thrombosis is associated with Virchow's triad. This involves the combination of hypercoagulability, damage to the vessel endothelium and haemodynamic changes in the form of stasis or turbulence. These features ultimately contribute to thrombosis formation

Venous thrombosis can affect the eyes, resulting in serious ocular symptoms and is a significant cause of vision loss worldwide (Rogers, McIntosh et al. 2010). In the eye, venous thrombosis can result in a branch or a central retinal vein occlusion. The eye can also be affected by systemic venous thrombosis such as that which occurs in cerebral venous sinus thrombosis presenting with papilloedema, or in anti-phospholipid syndrome resulting in

In this chapter, we will discuss the ocular features of venous thrombosis, the presentation of retinal vein occlusion, and its ocular and systemic management. We will then examine the

Retinal venous obstruction occurs as a result of Virchow's triad in the retinal vessels with stasis, hypercoagulability and endothelial change. In the retina, disruption of venous return results in elevated intravascular pressure and culminates in retinal haemorrhage and oedema. Retinal ischaemia then follows, leading to non-perfusion of the capillary beds. Retinal vein occlusion RVO can be classified as either a branch retinal vein occlusion (BRVO) (Figure 1) or a central retinal vein occlusion (CRVO) (Figure 2) depending upon the location of the obstruction (Hayreh 2005). Each of BRVO and CRVO can be further sub-

Ischaemic RVO is characterised by retinal capillary non-perfusion and results in more severe signs and symptoms including significant decrease in visual acuity, cotton wool spots (indicating retinal ischaemia) and a relative afferent pupil defect. An ischemic RVO is

In non-ischaemic RVO stasis of the retinal veins occurs. There is leakage from the capillary bed but capillary perfusion is still present. A non-ischaemic RVO is associated with decreased visual acuity as a result of leaking retinal capillaries that cause macular

usually associated with ocular complications such as intraocular neovascularisation.

retinal arteriole occlusion, ischemic optic or cranial neuropathies.

ophthalmic manifestations of systemic venous thrombosis.

classified into ischaemic and non-ischaemic categories.

**1. Introduction** 

**2. Retinal vein occlusion** 

**2.1 Pathogenesis** 

oedema.

(Heit 2008).

Bob Z. Wang and Celia S. Chen

*Flinders Medical Centre and Flinders University* 

professionals from the American Heart Association/American Stroke Association. *Stroke* 42(4): 1158-1192.

