Retinal Vein Occlusions

Publication Date: February 1, 2020
Last Updated: March 14, 2022


The prognosis of retinal vein occlusions (RVOs) varies according to the site of the occlusion and the type of occlusion (ischemic or nonischemic). In general, more-distal RVOs with less occlusion have a better prognosis than more-proximal RVOs with greater ischemia.

Central retinal vein occlusions (CRVOs) and hemi-CRVOs have clinically similar courses. They are associated with glaucoma and have a higher risk of anterior segment neovascularization and neovascular glaucoma. Branch retinal vein occlusions (BRVOs) and hemiretinal vein occlusions have a visible arterial-venous crossing where the occlusion occurs.

Macular edema may complicate both CRVOs and BRVOs. The first line of treatment for associated macular edema is anti-vascular endothelial growth factors (anti-VEGFs). Intravitreal corticosteroids, with the associated risk of glaucoma and cataract formation, have demonstrated efficacy. Also, laser photocoagulation surgery in BRVO has a potential role in treatment.

Optimizing control of systemic arterial hypertension, diabetes, serum lipid levels, and intraocular pressure (IOP) to control glaucoma are all important in the management of systemic risk factors, as is communicating end-organ damage to the primary care provider. (, , )

Recommendation Grading




Retinal Vein Occlusions

Authoring Organization

Publication Month/Year

February 1, 2020

Last Updated Month/Year

July 5, 2023

Supplemental Implementation Tools

Document Type


External Publication Status


Country of Publication


Document Objectives

Identify patients at risk for developing RVO. Encourage management of potential risk factors for both CRVO and BRVO, including optimizing systemic blood pressure and diabetes as well as control of glaucoma and ocular hypertension. Increase primary care awareness of the higher risk of cardiovascular and stroke complications in patients presenting with RVO. Monitor for signs of posterior or anterior segment neovascularization and neovascular glaucoma following all RVOs, because nonischemic can become ischemic. Treat patients who have vision loss or those at risk for vision loss after RVO. Minimize treatment side effects that might adversely impact vision and/or vision-related quality of life. Provide or refer the patient for visual rehabilitation services when permanent visual impairment results from the disease

Inclusion Criteria

Female, Male, Adult, Older adult

Health Care Settings

Ambulatory, Emergency care, Hospital, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant


Diagnosis, Management

Diseases/Conditions (MeSH)

D012170 - Retinal Vein Occlusion, D014786 - Vision Disorders


vision loss, retinal vein occlusion

Source Citation

Flaxel, C. J., Adelman, R. A., Bailey, S. T., Fawzi, A., Lim, J. I., Vemulakonda, G. A., & Ying, G. (2019). Retinal Vein Occlusions Preferred Practice Pattern®. Ophthalmology. doi:10.1016/j.ophtha.2019.09.029

Supplemental Methodology Resources

Methodology Supplement


Number of Source Documents
Literature Search Start Date
March 1, 2018
Literature Search End Date
June 1, 2019