A prospective study of acute central retinal artery obstruction. The incidence of secondary ocular neovascularization
J. S. Duker, A. Sivalingam, G. C. Brown and R. Reber
Retina Vascular Unit, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pa.
We conducted a prospective study to determine the incidence of ocular
neo-vascularization following acute central retinal artery obstruction.
Only patients initially evaluated within 7 days of visual loss were
eligible. Any patient with pre-existing ocular neovascularization or
clinical evidence of the ocular ischemic syndrome noted at the initial
evaluation was excluded. During the 18-month study, 33 consecutive patients
were enrolled. Six patients subsequently developed neovascularization of
the iris, an incidence of 18.2%. In these six patients, neovascularization
of the iris appeared as early as 12 days to as late as 15 weeks following
the artery obstructions. Five of the six patients (15.2% of the total)
later developed neovascular glaucoma. Another patient in this series
developed neovascularization of the optic disc without neovascularization
of the iris, an incidence of 3.0%. Only two of the seven patients with
ocular neovascularization had ipsilateral hemodynamically significant
carotid artery disease as determined by noninvasive carotid artery testing.
This study confirms results of previous retrospective studies that the
incidence of ocular neovascularization after central retinal artery
obstruction is higher than commonly thought. It also shows that, in the
majority of cases, carotid artery disease is not responsible for the
neovascularization seen after central retinal artery obstruction.
