Managing retinal vein occlusion

Retinal vein occlusion—obstruction of the retinal venous system by thrombus formation, external compression, or disease of the vein wall1—is the second most common retinal vascular disease after diabetic retinopathy.2 Pooled data from population studies in the United States, Europe, Asia, and Australia suggest that about 16 million adults are affected by this condition.3 Not all cases need treatment. In the past, the visual prognosis for most patients was poor because treatment comprised lowering the pressure in the eye, if raised, and laser treatment to try to control associated complications. However, two new treatments have recently been licensed in the US and the European Union, one of which has been approved by the National Institute for Health and Clinical Excellence (NICE) for use in England and Wales. Consequently, the outlook for patients with retinal vein occlusion is likely to improve. We review the diagnosis and management of retinal vein occlusion and examine the evidence for the effectiveness of the newly licensed drugs.