What initial investigations should be performed in a patient suspected

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

If a retinal vein occlusion (RVO) is suspected, the initial and crucial step in general practice is to arrange an urgent referral for ophthalmology assessment and investigations ,. This is particularly important if the person presents with rapid-onset visual loss or visual distortion (metamorphopsia) ,. Ideally, the patient should be seen within one week of referral ,.

Upon specialist assessment, investigations typically performed in a hospital eye service or fast-track retina clinic include:
Slit-lamp biomicroscopy, which helps identify changes affecting the macula, such as haemorrhagic or exudative changes, and can detect retinal thickening ,.
Colour fundus photography, used to provide a record of the retina's appearance ,.
Optical coherence tomography (OCT), a non-invasive imaging technique that produces high-resolution cross-sectional and three-dimensional images of the retina ,. This test is considered mandatory for diagnosis and monitoring response to therapy in some retinal conditions ,.
Fluorescein angiography (FFA), which involves an intravenous dye injection to detect abnormal vasculature or leakage from capillaries ,.
Indocyanine green angiography (ICG), which may be used to visualise the choroidal circulation and provides additional information to FFA ,.

It is noted in literature that retinal vascular occlusions have been reviewed in the context of COVID-19 infection and vaccination .

What initial investigations should be performed in a patient suspected of having retinal vein occlusion?

Key References

What initial investigations should be performed in a patient suspected of having retinal vein occlusion?

Key References

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