Management of retinal venous occlusion

The conservative treatment as well as photocoagulative therapy of central retinal and branch vein occlusion is reported on. In spite of encouraging reports in the literature on medical treatment with anticoagulants and antithrombocyte aggregation drugs, photocoagulation via the xenon-arc or argon-laser method should be preferred. The indication for photocoagulation depends on fluorescein angiographical controls with the ability to distinguish between reversible and irreversible retinal changes, thus assuming prognostic significance. In cases of central retinal vein occlusion one should begin with photocoagulation soon after the onset of the disease to prevent new vessel formation in the retina and iris with following vitreal hemorrhage and secondary angle-closure glaucoma. In cases of branch vein occlusion a more conservative approach with regular fluorescein angiographical controls are proposed, because the natural course and the prognosis without therapy will be good in most cases.