From the Research
Central retinal vein occlusion (CRVO) and arrhythmias are related through shared cardiovascular risk factors and pathophysiology, and patients with CRVO should undergo cardiac evaluation, including ECG and possibly Holter monitoring, to detect underlying arrhythmias, as supported by the most recent study 1. The relationship between central retinal vein occlusion and arrhythmia is complex and multifaceted, involving shared risk factors such as hypertension, diabetes, and hyperlipidemia, which can lead to endothelial dysfunction, hypercoagulability, and inflammation 2, 3, 4.
Key Considerations
- The pathogenesis of CRVO is not yet fully understood, but it is known to involve intraluminal thrombus formation, which can be secondary to various conditions, including hypertension, hyperlipidemia, diabetes, and thrombophilia 2.
- Anti-VEGF agents, such as ranibizumab, aflibercept, and bevacizumab, have become a common treatment for CRVO, with the aim of improving clinical outcomes in these patients 2, 5.
- A recent study found that CRVO and branch retinal vein occlusion (BRVO) can be well-managed by intravitreal treatments, with significant visual acuity improvement and central macular thickness recovery 1.
Management
- Management of CRVO and arrhythmias should be simultaneous, with anti-VEGF injections as first-line treatment for CRVO, and arrhythmia management depending on the specific type, including rate control medications, rhythm control, or anticoagulation for atrial fibrillation.
- Cardiovascular risk factor modification is essential, including blood pressure control, lipid management, glycemic control in diabetes, smoking cessation, and weight management 3, 4.
Outcome
- The connection between CRVO and arrhythmias stems from shared pathophysiology involving endothelial dysfunction, hypercoagulability, and inflammation, and both conditions reflect systemic vascular disease requiring comprehensive cardiovascular risk assessment and management 1.
- Arrhythmias, particularly atrial fibrillation, can create conditions for thrombus formation that may embolize to retinal vessels, highlighting the importance of early detection and management of arrhythmias in patients with CRVO 1.