Incidence1
  • 5-year incidence of 0.2%
    • Population-based study of 4926 patients in Beaver Dam, Wisconsin; evaluated at baseline (1988-1990) and at 5-year follow-up (1993-1995)

Symptoms
  • Sudden painless vision loss is typical, but vision loss may also occur gradually over a period of days to weeks2,3

Diagnosis
  • Suspect central retinal vein occlusion in patients with painless vision loss, especially if risk factors are present3
  • Fundoscopy confirms the diagnosis, often revealing widespread retinal hemorrhages, venous engorgement and tortuousness, cotton wool spots, macular edema, and optic disc edema3,4
  • Diagnostic workup should include evaluation for hypertension, glaucoma, and diabetes3
  • Young patients are tested for increased blood viscosity3

Common risk factors3 Potential complications3,4
  • Hypertension
  • Age
  • Glaucoma
  • Diabetes
  • Increased blood viscosity
  • Neovascular glaucoma can occur within a few weeks and up to 1 to 2 years after occlusion
  • Retinal neovascularization may lead to vitreous hemorrhage

Potential impact of untreated CRVO
  • Most patients will have some visual deficit3
  • Nonischemic CRVO: In about 50% of patients, final visual acuity may be 20/200 or worse.4 In the first 6 to 12 months after presentation, one-third of patients may progress to ischemic CRVO4
  • Ischemic CRVO: In more than 90% of patients, final visual acuity may be 20/200 or worse.4 More than 60% of patients develop neovascular glaucoma due to anterior segment neovascularization, which may occur within a few weeks and up to 1 to 2 years afterward4
    • Complications have been described as “devastating”4

Fundoscopy showing evidence of CRVO
  • Macular edema

  • Venous engorgement and tortuousness

  • Hemorrhages

  • Cotton wool spots


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Or click below to see OZURDEX® clinical data

Indications and Usage
Retinal Vein Occlusion
OZURDEX® (dexamethasone intravitreal implant) is a corticosteroid indicated for the treatment of macular edema following branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO).

Posterior Segment Uveitis
OZURDEX® is indicated for the treatment of noninfectious uveitis affecting the posterior segment of the eye.

Dosage and Administration
FOR OPHTHALMIC INTRAVITREAL INJECTION ONLY. The intravitreal injection procedure should be carried out under controlled aseptic conditions. Following the intravitreal injection, patients should be monitored for elevation in intraocular pressure and for endophthalmitis. Patients should be instructed to report any symptoms suggestive of endophthalmitis without delay.

Important Safety Information
Contraindications
Ocular or Periocular Infections: OZURDEX® (dexamethasone intravitreal implant) is contraindicated in patients with active or suspected ocular or periocular infections including most viral diseases of the cornea and conjunctiva, including active epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella, mycobacterial infections, and fungal diseases.

Advanced Glaucoma: OZURDEX® is contraindicated in patients with advanced glaucoma.

Hypersensitivity: OZURDEX® is contraindicated in patients with known hypersensitivity to any components of this product.

Warnings and Precautions
Intravitreal Injection-related Effects: Intravitreal injections have been associated with endophthalmitis, eye inflammation, increased intraocular pressure, and retinal detachments. Patients should be monitored regularly following the injection.

Potential Steroid-related Effects: Use of corticosteroids may produce posterior subcapsular cataracts, increased intraocular pressure, glaucoma, and may enhance the establishment of secondary ocular infections due to bacteria, fungi, or viruses.

Corticosteroids should be used cautiously in patients with a history of ocular herpes simplex.

Risk of Implant Migration: Patients in whom the posterior capsule of the lens is absent or has a tear are at risk of implant migration into the anterior chamber.

Adverse Reactions
The most common ocular adverse reactions reported by greater than 2% of patients in the first 6 months following injection of OZURDEX® for retinal vein occlusion and posterior segment uveitis include: intraocular pressure increased (25%), conjunctival hemorrhage (22%), eye pain (8%), conjunctival hyperemia (7%), ocular hypertension (5%), cataract (5%), vitreous detachment (2%), and headache (4%).

Increased IOP with OZURDEX® peaked at approximately week 8. During the initial treatment period, 1% (3/421) of the patients who received OZURDEX® required surgical procedures for management of elevated IOP.

Please see full Prescribing Information. Click here.

References:
  • Klein R, Klein BE, Moss SE, Meuer SM. The epidemiology of retinal vein occlusion: the Beaver Dam Eye Study. Trans Am Ophthalmol Soc. 2000;98:133-141.
  • Aetna InteliHealth®. Retinal vessel occlusion. http://www.intelihealth.com/IH/ihtIH?t=9953&p=~br,IHW|~st,24479|~r,WSIHW000|~b,*|. Accessed September 21, 2010.
  • Garg SJ. Central retinal vein occlusion. The Merck Manuals Online Medical Library website. http://www.merck.com/mmpe/sec09/ch106/ch106d.html. Updated December 2008. Accessed September 21, 2010.
  • Kooragayala LM. Central retinal vein occlusion. eMedicine website. http://emedicine.medscape.com/article/1223746-overview. Updated May 26, 2009. Accessed September 21, 2010.
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