Current Understanding of Retinal Vein Thrombosis in Older Adults: A Review of the Literature

Retinal vein thrombosis (RVT) represents a global public health problem, ranking as the second position in prevalence among all retinal vascular pathologies and becoming an "epidemic" with the advanced age of patients. The prevalence of this pathology increases 20 times in patients aged over 80 years, compared to the age of 40-49 years. This pathology can lead to visual impairment, blindness and causes disability, but it is reversible within the first 7 days with timely diagnosis and treatment. The response to anti-VEGF treatment is better with earlier initiation. VEGF suppression not only improves macular edema but also reopens some closed retinal vessels, prevents the progression of vessel closure, and improves retinopathy. Consequently, early diagnosis, competent treatment and rehabilitation, especially in older adults with retinal vascular pathology, are necessary to prevent vision loss and disability. However, there is a lack of studies on mechanisms of RVT development in this demographic group.

To provide a synthesis of the literature regarding the evaluation risk factors and pathogenesis of ocular vascular pathology, with special emphasis on examination methods, clinical characteristics, complications and modern treatment strategies in older adults with retinal vein thrombosis.

PubMed, Web of Science and Cochrane Library were searched for studies, systematic reviews or meta-analyses reporting the relationship between the central retinal vein (CRV) or its branches thrombosis and patient age in the period from 2015 to 2024. Population-based or cohort studies with maximum population inclusion were selected.

Analysis of modern methods examination - fluorescence angiography of the ocular fundus (FA), an angio-optical coherence tomography (Angio-OCT) study of the retina and Fluorescence angiography allows revealing important pathogenetic aspects of retinal vein occlusion. Understanding all epidemiological, pathogenetic and diagnostic aspects in older adults is paramount for RVT timely effective prevention, clinical intervention and rehabilitation.

The prevalence of retinal vein occlusion increases significantly with age. It is associated with an increase in stroke, cardiovascular events, and mortality. This requires monitoring and treating vascular risk factors.