Ocular neovascularization with retinal vascular occlusion. II. Occurrence in central and branch retinal artery occlusion
S. S. Hayreh and P. Podhajsky
Sixty-one patients (64 eyes) with central retinal artery occlusion (CRAO)
and 41 patients (44 eyes) with branch retinal artery occlusion (BRAO) were
studied in detail clinically to find out the pathogenesis of their ocular
neovascularization (NV). Ocular NV was seen in 12 eyes (11 patients) with
CRAO: iris NV was seen in all 12 eyes, angle NV was seen with neovascular
glaucoma (NVG) in ten of them, and no NV was seen in BRAO. Nine of ten
patients with CRAO associated with NVG were old, having severe carotid
artery disease (CAD) and severe generalized atherosclerotic arterial
disease; in the remaining patient, NVG was caused by diabetes mellitus.
Severe CAD results in chronic ocular ischemia, which, in turn, produces NV
of the iris and angle and NVG; the latter, combined with poor perfusion
pressure in the central retinal artery (caused by severe CAD), results in
CRAO. Our study showed little evidence that CRAO, per se, is responsible
for ocular NV. Various evidence in support of this hypothesis is presented.
Our study also showed that the only eyes to recover good vision were those
with transient CRAO for up to 11/2 hours, and no treatment helped.
