Retinal Vein Occlusion

Retinal vein occlusion (RVO) occurs when blood flow is impaired anywhere from the central retinal vein to the small retinal veins, causing hemorrhage, edema, and exudation in the corresponding retinal area. Clinically, it is commonly classified as central retinal vein occlusion, hemi-retinal vein occlusion, or branch retinal vein occlusion. In traditional Chinese medicine (TCM), this condition falls under the category of “dim vision.”

TCM Pattern Differentiation and Medication Reference

|Common Symptoms

Clinical Description:

This pattern is seen within 1–2 weeks of hemorrhage onset. Vision suddenly deteriorates. Flame-shaped retinal hemorrhages are visible in the fundus, distributed along the course of the veins and bright red in color. Cotton-wool-like exudates are often present. The tongue is red with a thin, yellow coating, and the pulse is wiry and rapid.

In Plain Language:

  • Symptoms often begin within one to two weeks after bleeding occurs.
  • Vision may suddenly worsen, making things appear much blurrier.
  • Flame-shaped streaks of bleeding may be seen in the retina at the back of the eye.
  • The bleeding follows the course of the veins, spreading in streaks alongside the blood vessels.
  • The bleeding is bright red in appearance.
  • White, cotton-wool-like patches of exudation are often present.
  • The tongue appears red and somewhat bright in color.
  • The tongue coating is thin and slightly yellow, appearing as a light layer on the tongue.
  • The pulse feels taut and fast, like a tightened string.

|Treatment Approach

Clinical Description:

Primarily cool the blood and stop bleeding, while also promoting blood circulation and resolving stasis.

In Plain Language:

  • First, clear heat from the blood and help stop the bleeding.
  • At the same time, promote smooth blood flow and help disperse blood stasis.

|Related Products

The following products are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

|Common Symptoms

Clinical Description:

Blurred vision; dark-red fundus hemorrhages; indistinct optic disc margins, with edema often obscured by hemorrhage; narrowed arteries, often with sclerosis; dilated, tortuous veins; retinal macular edema with star-shaped exudates or cystoid macular edema. Heaviness in the head and dizziness; chest tightness and epigastric fullness; cough with copious phlegm. The tongue has stasis spots with a white, greasy coating, and the pulse is wiry or slippery.

In Plain Language:

  • Vision appears blurred.
  • Dark-red areas of bleeding appear in the fundus.
  • The edge of the optic nerve is difficult to see, and swelling is often obscured by bleeding.
  • The arteries in the fundus are narrowed, and their walls may be stiff and less flexible.
  • The veins in the fundus are dilated and winding.
  • Swelling and fluid accumulation occur in the central area of the fundus.
  • Star-shaped exudates or cyst-like swelling may be seen in the central area.
  • The head feels heavy, sometimes with dizziness.
  • There is tightness in the chest and fullness or discomfort in the upper abdomen.
  • There may be a pronounced cough with copious, difficult-to-clear phlegm.
  • Dark-red or purple spots may be visible on the tongue.
  • The tongue coating is white and greasy.
  • The pulse feels taut like a string or slippery to the touch.

|Treatment Approach

Clinical Description:

Dispel blood stasis and transform phlegm; nourish and invigorate the blood.

In Plain Language:

  • Promote blood flow and help disperse stasis, easing stabbing or distending pain and dark discoloration from blood stasis.
  • Transform thick phlegm and soften and disperse accumulations, addressing chest tightness, phlegm with coughing, and nodules or masses.
  • Nourish the blood and promote circulation, with the aim of improving complexion and fatigue and supporting tissue repair.

|Related Products

The following products are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

Wu Ling San
Er Chen Tang
Xue Fu Zhu Yu Tang

|Common Symptoms

Clinical Description:

Decreased vision; dark-red fundus hemorrhages; indistinct optic disc margins, often obscured by hemorrhage; dilated and tortuous arteries; retinal macular edema. Fullness and pain in the chest and flanks; irritability and anger; flushed face and ears; dizziness; bitter taste in the mouth and dry throat. The tongue is red with a yellow coating, and the pulse is wiry and rapid.

In Plain Language:

  • Vision declines, and things appear blurrier.
  • Dark-red patches of bleeding may be seen in the fundus.
  • The edge of the optic disc is indistinct.
  • Bleeding obscures details and makes examination difficult.
  • The arteries in the fundus are dilated and winding.
  • Swelling and fluid accumulation occur in the central area of the fundus.
  • The chest and areas alongside the ribs feel distended and painful.
  • Irritability and anger may occur easily.
  • The face and ears become red and feel hot.
  • Dizziness or lightheadedness may occur.
  • There is a bitter taste in the mouth and dryness in the throat.
  • The tongue appears red.
  • The tongue coating is yellow.
  • The pulse feels taut and fast.

|Treatment Approach

Clinical Description:

Calm the Liver and drain fire; promote blood circulation and resolve stasis.

In Plain Language:

  • Settle Liver yang and reduce internal heat, addressing dizziness, a heavy or distended head, irritability, red eyes, and a bitter taste in the mouth.
  • Clear heat-related sensations of burning and restlessness, helping promote emotional and sleep stability.
  • Promote blood flow and help disperse stasis, addressing stabbing or distending pain, purplish discoloration under the skin, and localized hard nodules.

|Related Products

The following products are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

Long Dan Xie Gan Tang

|Common Symptoms

Clinical Description:

Decreased vision; fundus findings as described above. Dizziness, irritability, soreness and weakness in the lower back and knees, seminal emission, and fatigue. The tongue is deep red with no coating, and the pulse is wiry and thready.

In Plain Language:

  • Vision declines, and things appear blurrier.
  • The fundus findings are as described above.
  • Dizziness or vertigo may occur.
  • Irritability and anger may occur easily.
  • The lower back and knees feel sore and weak.
  • Seminal emission and fatigue may occur.
  • The tongue is deep red in color.
  • There is no noticeable coating on the tongue.
  • The pulse feels taut and thready.

|Treatment Approach

Clinical Description:

Nourish yin and subdue yang; promote blood circulation and resolve stasis.

In Plain Language:

  • Nourish the body’s fluids and yin while helping restrain upward-rising yang, addressing dizziness, irritability, hot flashes, and night sweats.
  • Promote smooth blood flow and help disperse stasis, addressing stabbing or distending pain and purplish discoloration under the skin.
  • Support circulation and nourishment, with the aim of gradually softening localized lumps and hard nodules.

|Related Products

The following products are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

Zhi Bai Di Huang Wan

|Common Symptoms

Clinical Description:

Decreased vision over a prolonged course; the retina appears turbid, and some hemorrhage has been absorbed, leaving dark blood. Occluded blood vessels appear as white lines. Fatigue and reluctance to speak; shortness of breath and weakness; dizziness and tinnitus; soreness in the lower back and weakness in the legs. The tongue is dusky and pale with stasis spots and teeth marks along the edges, and the pulse is deep and thready.

In Plain Language:

  • Vision declines, and things appear blurrier than before.
  • The condition has lasted a long time, with symptoms persisting or recurring and difficulty recovering.
  • The retina at the back of the eye appears dull and cloudy rather than clear.
  • Older bleeding in the fundus is gradually absorbed, leaving a dark or nearly black residual color.
  • Some blood vessels in the fundus are occluded and appear as thin white lines along their course.
  • The body feels tired, there is little desire to speak, and shortness of breath and fatigue occur easily.
  • The head feels dizzy and heavy, and there may be persistent ringing in the ears.
  • The lower back aches and feels weak, and both legs feel weak and fatigued.
  • The tongue is dusky in color, with dark stasis spots or patches on its surface.
  • The pulse is felt only with deeper pressure and is thin and weak.

|Treatment Approach

Clinical Description:

Tonify qi, invigorate the blood, resolve stasis, and unblock the collaterals.

In Plain Language:

  • Support energy and stamina, addressing shortness of breath, weakness, and easy fatigue.
  • Promote smooth blood flow, addressing stabbing or distending pain and purplish discoloration under the skin.
  • Help disperse stasis and unblock the channels and collaterals, addressing numbness, stiffness, and pulling discomfort.
  • Support peripheral circulation and oxygen supply, with the aim of warming the hands and feet and reducing swelling and heaviness.

|Related Products

The following products are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

Si Jun Zi Tang

References

  1. Jin Ming. Annotations to the TCM Clinical Diagnosis and Treatment Guidelines: Ophthalmology [M]. Beijing: China Press of Traditional Chinese Medicine, 2015: 107–108.
  2. Li Jianhua. Clinical observation of He Xue Ming Mu Pian for the treatment of retinal vein occlusion [J]. International Journal of Ophthalmology, 2014(10): 1882–1883.
  3. Song Lijun. Clinical efficacy of Zhi Xue Qu Yu Ming Mu Pian in the treatment of non-ischemic retinal vein occlusion [J]. Chinese Journal of Clinical Rational Drug Use, 2014, 7(36): 136–138.
  4. Bai Jinping. Observation of the efficacy of urokinase combined with He Xue Ming Mu Pian in the treatment of vitreous hemorrhage [J]. Chinese Community Doctors (Medical Edition), 2012(3): 176.
  5. Zhong Chunmei. Study of the preventive and therapeutic effects and mechanisms of Dan Hong Hua Yu Oral Liquid on diabetic retinopathy [D]. Guangzhou University of Chinese Medicine, 2014.
  6. Zhu Huiming, Jiang Yu, Li Ling, et al. Dan Hong Hua Yu Oral Liquid for the treatment of nonproliferative diabetic retinopathy [J]. Chinese Journal of Experimental Traditional Medical Formulae, 2013(17): 320–323.
  7. Zhang Chunyu, Liu Ziqi, Hu Baorong. Dan Hong Hua Yu Oral Liquid for the treatment of fundus hemorrhage: a report of 86 cases [J]. Chinese Journal of Traditional Medical Science and Technology, 2011(6): 509.
  8. Wang Feng, Yang Zhiyan, Su Ying, et al. Clinical observation of Dan Hong Hua Yu Oral Liquid for the treatment of retinal vein occlusion [J]. Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care, 2001(3): 178.
  9. Liu Heng, Liu Aimin, Gao Li, et al. Compound Xue Shuan Tong Capsules for the treatment of 60 cases of retinal vein occlusion [J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2010(12): 1497–1498.
  10. Jin Ming. Series on the Rational Clinical Use of Chinese Patent Medicines for Common Diseases: Ophthalmology [M]. Beijing: Huaxia Publishing House, 2015: 120–158.