Branch Retinal Vein Occlusion (BRVO)

What is Branch Retinal Vein Occlusion (BRVO)? Branch retinal vein occlusion (BRVO) is a subtype of retinal vein occlusion that occurs in response to the formation of a thrombus in a branch of the distal retinal vein system or when an overlying arteriole compresses a branch retinal vein at arteriovenous crossing sites. BRVO occurs more commonly than central retinal vein occlusion (CRVO), affecting approximately 1.8% of adults in the United States.

Risk Factors of Branch Retinal Vein Occlusion

Risk factors of BRVO include:

  • Increased age
  • Hypertension
  • Hyperlipidemia
  • Atherosclerosis
  • High BMI

Signs and Symptoms of Branch Retinal Vein Occlusion 

Patients with BRVO are often asymptomatic and only affect the part of the retina drained by the affected branch. Loss of vision is usually associated with macular edema and retinal detachment. Other symptoms may include

  • Blurred or distorted vision
  • Visual field loss
  • Floaters
  • Decreased color vision

Clinical Signs that May be Visible on Fundoscopy in the Affected Area of the Retina:

  • Sectional retinal hemorrhages
  • Cotton wool spots
  • Retinal edema
  • Dilated, tortuous retinal vein
  • Hard exudates
  • Microaneurysms
  • Tractional retinal detachment
  • Retinal neovascularization 

Source: Scott, I. U., Campochiaro, P. A., Newman, N. J., & Biousse, V. (2020). Retinal vascular occlusions. The Lancet, 396(10266), 1927–1940.