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# Other retinal vascular disease: ROP and occlusions

- Lesion

Premature birth, sickle cell disease, inflammation, radiation and blocked arteries or veins all injure retinal vessels in their own way.

Updated Nov 12, 2026

## Key points

- Retinopathy of prematurity: risk rises with lower gestational age and birth weight and unmonitored oxygen; peripheral avascular retina, ridge, neovascularisation, tractional detachment (retrolental fibroplasia).
- Sickle retinopathy: peripheral arteriolar occlusion, sea-fan neovascularisation; more frequent in hemoglobin SC disease.
- Retinal vasculitis: Behçet disease, sarcoidosis, tuberculosis, multiple sclerosis.
- Radiation retinopathy: delayed capillary closure, microaneurysms and new vessels, resembling diabetes.
- Central retinal artery occlusion: pale swollen inner retina with a cherry-red spot at the fovea; consider giant cell arteritis and carotid emboli.
- Central retinal vein occlusion: ‘blood and thunder’ fundus with hemorrhages in all quadrants; risk of neovascular glaucoma.

## What it is

Several conditions share the sequence of retinal ischemia followed by abnormal new vessels. In retinopathy of prematurity, the incompletely vascularised retina of a preterm infant is first exposed to relatively high oxygen and then becomes ischemic, driving VEGF and neovascularisation. Sickle cells occlude peripheral retinal vessels, causing ‘sea-fan’ new vessels. Retinal vasculitis and radiation injure vessel walls. Central retinal artery occlusion infarcts the inner retina within minutes, while vein occlusion causes hemorrhage and edema.

## Step by step

- In the preterm infant, the retinal periphery is not yet vascularised.
- Relatively high oxygen after birth suppresses VEGF and stops normal vessel growth.
- As the retina matures it becomes ischemic and releases VEGF.
- Abnormal vessels grow at the ridge into the vitreous.
- Fibrovascular tissue contracts and can detach the retina.

## Retinal vascular disorders beyond diabetes and hypertension

| Disorder | Mechanism | Key sign | Complication |
| --- | --- | --- | --- |
| [Retinopathy of prematurity](https://durgical.com/en/conditions/retinopathy-of-prematurity/) | Oxygen shifts in immature retina, VEGF | Ridge between vascular and avascular retina | Tractional detachment |
| [Sickle retinopathy](https://durgical.com/en/conditions/sickle-cell-disease/) | Peripheral vessel occlusion by sickled cells | Sea-fan neovascularisation | Vitreous hemorrhage, detachment |
| [Retinal vasculitis](https://durgical.com/en/conditions/behcet-disease/) | Immune or infectious inflammation of vessels | Vessel sheathing | Occlusion, neovascularisation |
| Radiation retinopathy | Endothelial injury | Microaneurysms, cotton-wool spots | Neovascularisation |
| [Central retinal artery occlusion](https://durgical.com/en/conditions/central-retinal-artery-occlusion/) | Embolus or arteritis | Pale retina, cherry-red spot | Permanent visual loss |
| [Central retinal vein occlusion](https://durgical.com/en/conditions/central-retinal-vein-occlusion/) | Thrombus at the lamina cribrosa | Diffuse hemorrhages, swollen disc | Macular edema, neovascular glaucoma |

## Clinical notes

- Colombia screens preterm infants for retinopathy of prematurity; treatment by laser or anti-VEGF prevents blindness.
- Sudden painless loss of vision in one eye is an emergency; in older adults, giant cell arteritis must be considered.

## Memory aid

Too much oxygen first, too little later: the premature retina stops growing vessels, then grows the wrong ones.

## Test yourself

Think of the answer, then tap the question to see it.

## Why does central retinal artery occlusion produce a cherry-red spot?

The infarcted inner retina turns opaque and white, while the thin fovea lets the normal red choroid show through.

## What is sea-fan neovascularisation?

Fan-shaped new vessels in the peripheral retina after vessel occlusion in sickle cell disease, especially hemoglobin SC.

## What drives the abnormal vessels in retinopathy of prematurity?

VEGF released by ischemic, incompletely vascularised retina after an earlier phase of oxygen-induced vessel arrest.

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## Elsewhere in DurgiPedia

- [Retinopathy of prematurity: who to screen and when](https://durgical.com/en/ophthalmology/retinopathy-of-prematurity-who-to-screen-and-when/)
- [Sickle cell disease and the eye](https://durgical.com/en/ophthalmology/sickle-cell-disease-and-the-eye/)
- [Central retinal artery occlusion: an eye stroke](https://durgical.com/en/ophthalmology/central-retinal-artery-occlusion-an-eye-stroke/)
- [Central retinal vein occlusion: workup and follow-up](https://durgical.com/en/ophthalmology/central-retinal-vein-occlusion-workup-and-follow-up/)
- [Blood supply of the retina and choroid](https://durgical.com/en/ophthalmology/blood-supply-of-the-retina-and-choroid/)

## Connections

## Related 6

- [Diabetic and hypertensive retinopathy](https://durgical.com/en/general-pathology/diabetic-and-hypertensive-retinopathy/)
- [Optic neuropathies](https://durgical.com/en/general-pathology/optic-neuropathies/)
- [Infarction: red vs white, and what decides the damage](https://durgical.com/en/general-pathology/infarction-red-vs-white-and-what-decides-the-damage/)
- [Ionizing radiation injury](https://durgical.com/en/general-pathology/ionizing-radiation-injury/)
- [Sickle cell disease](https://durgical.com/en/general-pathology/sickle-cell-disease/)
- [Prematurity and fetal growth restriction](https://durgical.com/en/general-pathology/prematurity-and-fetal-growth-restriction/)

## Related conditions 7

- [Retinopathy of prematurity](https://durgical.com/en/conditions/retinopathy-of-prematurity/)
- [Sickle cell disease](https://durgical.com/en/conditions/sickle-cell-disease/)
- [Central retinal artery occlusion](https://durgical.com/en/conditions/central-retinal-artery-occlusion/)
- [Central retinal vein occlusion](https://durgical.com/en/conditions/central-retinal-vein-occlusion/)
- [Giant cell arteritis](https://durgical.com/en/conditions/giant-cell-arteritis/)
- [Behçet disease](https://durgical.com/en/conditions/behcet-disease/)
- [Carotid artery stenosis](https://durgical.com/en/conditions/carotid-artery-stenosis/)

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Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.

Sources: [Retinopathy of prematurity: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/001618.htm) (MedlinePlus, US National Library of Medicine, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/general-pathology/other-retinal-vascular-disease-rop-and-occlusions/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/other-retinal-vascular-disease-rop-and-occlusions/