Anticoagulants, antiplatelet agents, fibrinolytics, and thrombolytics have no therapeutic value and may be harmful. Other therapies that have been used but found to be ineffective include surgical decompression, low molecular weight dextran, hemodilution, and carbon dioxide inhalation. Not all patients will respond. Patients with vasculitis may show marked improvement. Acetazolamide in nonischemic RVO, some patients will have decreased macular edema as long as they remain on the medication.
Photocoagulation is currently the treatment of choice.
However, considerable debate continues regarding whom the treatment may benefit. Ophthalmologic consultation is mandatory. Management is outside the scope of emergency medicine. The goal of therapy is to reduce macular edema. In addition, these agents modify the body's immune response to diverse stimuli.