Comparison chart of retinal vascular diseases. Take reference from kanki

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I now have comprehensive data from Kanski's Clinical Ophthalmology (10th edition) to compile the comparison chart. Here it is:

Comparison Chart of Retinal Vascular Diseases

Reference: Kanski's Clinical Ophthalmology — A Systematic Approach, 10th Edition

Overview Table

Feature	BRVO (Branch RVO)	Non-ischaemic CRVO	Ischaemic CRVO	BRAO (Branch RAO)	CRAO (Central RAO)	Hypertensive Retinopathy	Diabetic Retinopathy
Vessel involved	Branch retinal vein	Central retinal vein	Central retinal vein	Branch retinal artery	Central retinal artery	Arterioles (all)	Capillaries + venules
Pathology	Arteriosclerosis → compression at AV crossing → thrombosis	Atherosclerosis of CRA compresses CRV at lamina cribrosa; haematological prothrombotic factors	Same as non-ischaemic, more severe	Embolism (cholesterol, calcific, fibrin-platelet)	Embolism or thrombosis	Hypertensive arteriolar changes → endothelial damage	Hyperglycaemia → pericyte loss, microaneurysms, capillary leakage, neovascularisation
Typical aetiology	Hypertension (most common), hyperlipidaemia	Hypertension, hyperlipidaemia, thrombophilia	As non-ischaemic ± higher VEGF load	Carotid artery disease, cardiac emboli	Carotid/cardiac emboli, GCA, thrombosis	Systemic arterial hypertension	Type 1 or Type 2 diabetes mellitus
Age group	>50 years (usually)	Younger than ischaemic CRVO	>50 years	Any age; risk increases >50	>50 years	Adults with chronic hypertension	Adults; T1DM younger
Laterality	Unilateral	Unilateral	Unilateral	Unilateral	Unilateral	Bilateral	Bilateral

Symptoms & Vision

Feature	BRVO	Non-ischaemic CRVO	Ischaemic CRVO	BRAO	CRAO	Hypertensive Retinopathy	Diabetic Retinopathy
Visual loss	Sudden blurred vision; may be asymptomatic if peripheral	Sudden painless monocular fall in vision	Sudden severe painless monocular loss	Sudden profound painless altitudinal/sectoral field loss	Sudden profound painless loss	Often asymptomatic until advanced; blurred vision in grade 3–4	Gradual; may be asymptomatic early; sudden in vitreous haemorrhage
VA at presentation	Variable; depends on macular involvement	Variable (6/9–HM); VA <6/60 suggests ischaemia	Severely reduced (often <6/60)	Variable; poor if macula involved	Severely reduced; light perception absent in GCA/ophthalmic artery occlusion	Variable by grade	Variable; can be 6/6 with background DR
RAPD	Usually absent	Absent or mild	Present and significant	Often present	Profound (may be amaurotic pupil)	Absent	Usually absent

Fundus Signs

Sign	BRVO	Non-ischaemic CRVO	Ischaemic CRVO	BRAO	CRAO	Hypertensive Retinopathy	Diabetic Retinopathy
Haemorrhages	Flame + dot/blot in one quadrant (superotemporal most common)	Dot, blot, flame in all quadrants — mild to moderate	All quadrants — extensive	None or minimal	Absent or occasional small haemorrhage	Dot, blot, flame (grade 3+)	Dot (microaneurysms), blot, flame; in all quadrants
Cotton-wool spots	May be present	Common but mild	Present	Absent	May be present	Grade 3+	Background/pre-proliferative DR
Disc oedema	Absent	May be mild	Common	Absent	Absent (unless GCA)	Grade 4 (malignant HT)	Diabetic papillopathy
Macular oedema	Common (main cause of chronic poor VA)	Common	Severe	Present if macula involved	N/A (fovea infarcted)	Macular star (hard exudates in fovea)	Clinically significant macular oedema (CSMO)
Hard exudates	Present	Present	Present	Absent	Absent	Macular star pattern	Circinate pattern; CSMO
Venous changes	Dilated/tortuous in affected segment only	Mild–moderate dilatation + tortuosity ALL quadrants	Marked dilatation + tortuosity ALL quadrants	Normal or attenuated	Normal or attenuated	AV nipping (grade 2+)	Venous beading, loops (pre-proliferative)
Arterial changes	Normal	Normal	Normal	Attenuated; cattle-truck/box-car segmentation; emboli at bifurcation	Attenuated; cattle-trucking; cherry-red spot; emboli in 20%	Generalised narrowing (grade 1); focal narrowing (grade 2); copper/silver wiring	Microaneurysms; NVE/NVD in proliferative DR
Cherry-red spot	Absent	Absent	Absent	Absent	Classic finding	Absent	Absent
Neovascularization (NV)	NVE in ~8% at 3 yr; NVI/NVG rare (2–3%)	Uncommon	NVI/NVG in ~50% (most important complication)	Rare	Rare	Absent	NVE, NVD in proliferative DR; NVI
Collateral vessels	May form near ischaemic zones; better prognosis	Disc and peripheral collaterals	Disc collaterals	None	None	None	Intraretinal microvascular anomalies (IRMA)

Investigations

Test	BRVO	Non-ischaemic CRVO	Ischaemic CRVO	BRAO	CRAO	Hypertensive Retinopathy	Diabetic Retinopathy
FA	Peripheral/macular ischaemia; delayed venous fill; staining; collaterals	Impaired circulation; macular oedema; some ischaemia	Extensive capillary non-perfusion (>10 disc areas); prolonged A-V transit	Delayed arterial filling; hypofluorescence (retinal swelling blocks choroidal fluorescence)	Choroidal filling normal; CRA/branch non-filling; cilioretinal artery sparing if present	Leakage from disc and vessels	Microaneurysm leak; CMO; capillary non-perfusion; NV leak
OCT	Macular oedema; CMT	Macular oedema	Macular oedema + ischaemia	Inner retinal oedema/thinning	Inner retinal thinning	CME; SRF (choroidopathy)	Macular oedema; photoreceptor loss
ERG	Usually normal	Normal or subnormal	Subnormal b-wave (ischaemia marker)	Normal or reduced	Reduced	Normal	Subnormal

Classification

Feature	BRVO	CRVO	BRAO	CRAO	Hypertensive Retinopathy	Diabetic Retinopathy
Classification	Major (at disc / away from disc); Minor (macular); Peripheral	Impending → Non-ischaemic → Ischaemic	—	—	Keith-Wagener-Barker grades 1–4	Background → Pre-proliferative → Proliferative; ± Maculopathy
Grade 1 / Stage 1	—	Impending (mild, venous tortuosity, few haemorrhages)	—	—	Mild generalised arteriolar narrowing	Microaneurysms ± dot haemorrhages
Grade 2 / Stage 2	—	Non-ischaemic (<10 disc areas non-perfusion)	—	—	Focal narrowing + AV nipping ± copper wiring	+ Exudates, more haemorrhages, CWS
Grade 3 / Stage 3	—	Ischaemic (≥10 disc areas non-perfusion on FA)	—	—	Grade 2 + haemorrhages + exudates + CWS	+ Venous beading, IRMA (pre-proliferative)
Grade 4	—	—	—	—	Severe grade 3 + disc swelling (malignant HT)	Proliferative (NVD/NVE/NVI)

Complications

Complication	BRVO	Non-ischaemic CRVO	Ischaemic CRVO	BRAO	CRAO	Hypertensive Retinopathy	Diabetic Retinopathy
Chronic macular oedema	Most common cause of poor VA	Common	Severe	If macula involved	Foveal infarction	Macular star	CSMO (leading cause of blindness)
Neovascular glaucoma	2–3% at 3 yr	Uncommon	~50%	Rare	Rare	Absent	In advanced PDR
Vitreous haemorrhage	From NVE	Rare	From NVI/NVD	Rare	Rare	Absent	Common in PDR
Tractional RD	Occasionally	Rare	Can occur	Rare	Rare	Absent	PDR

Management Summary

Treatment	BRVO	Non-ischaemic CRVO	Ischaemic CRVO	BRAO	CRAO	Hypertensive Retinopathy	Diabetic Retinopathy
Anti-VEGF	First-line for macular oedema	First-line for macular oedema	For NVI/NVG prevention and macular oedema	Not established	Not established	Not applicable	First-line for DMO and high-risk PDR
Laser	Sector PRP for NVE/NVD; grid laser (second-line for CMO)	Not for prevention; PRP if ischaemia develops	PRP (panretinal photocoagulation) mandatory once ischaemia confirmed	Not indicated	Not indicated	Not indicated	PRP for high-risk PDR; focal/grid for DMO
Intravitreal steroids	Second-line for CMO	Dexamethasone implant	Dexamethasone implant	—	—	—	For refractory DMO
Acute intervention	—	—	—	Ocular massage; IOP lowering; AC paracentesis (within hours)	Same as BRAO + urgent workup for stroke/GCA	Control BP urgently	Optimise glycaemic control; BP control
Systemic workup	Treat HTN + hyperlipidaemia; thrombophilia screen if <50 yr	Thrombophilia screen; carotid + cardiac workup	Same as non-ischaemic CRVO	Carotid US; cardiac echo; same as TIA/stroke workup	Urgent stroke/GCA workup	Identify and treat underlying HTN	HbA1c, renal function, BP optimisation

Source: Kanski's Clinical Ophthalmology — A Systematic Approach, 10th Edition (ISBN 9780443110993), Chapter 13: Retinal Vascular Disease

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