 |
|
Clinical Course of Younger Patients With Central Retinal Vein Occlusion
Franco M. Recchia, MD;
Cynthia A. Carvalho-Recchia, MD;
Tarek S. Hassan, MD
Arch Ophthalmol. 2004;122:317-321.
Objective To describe the clinical course of patients 55 years and younger with central retinal vein occlusion (CRVO).
Design and Methods Retrospective, noncomparative case series. Medical records of 67 patients were reviewed for demographic, photographic, clinical, and visual acuity (VA) data. Data from 57 patients with at least 6 months of follow-up (mean, 29.2 months) were analyzed statistically.
Main Outcome Measures Best-corrected visual acuity and incidence of intraocular neovascularization.
Results Of 67 consecutive patients (55% men; mean age, 45 years), the median presenting VA was 20/50. Forty-five patients (67%) were found to have at least 1 systemic disease. In 57 patients with at least 6 months of follow-up, the final VA was 20/40 or better in 42%, 20/50 to 20/100 in 18%, and 20/200 or worse in 40%. Visual decline was most common within 3 to 6 months of CRVO onset. Visual improvement was uncommon after 12 months. Of the 22 patients with a presenting VA of 20/40 or better, 36% declined to 20/400 or worse at the most recent examination. Of the 10 patients with a presenting VA of 20/200 to 20/400, 8 improved to 20/60 or better. None of the 6 patients with a presenting VA of counting fingers or worse improved. Intraocular neovascularization was diagnosed at 1 to 9 months following CRVO in 10 patients (18%). Neovascularization of the anterior segment developed in 6 patients (11%), including neovascular glaucoma in 3 (5%). The occurrence of neovascularization appeared to be unrelated to sex, age, presence of associated disease, duration of symptoms, or presenting VA.
Conclusions Younger patients with CRVO have a variable clinical course. Presenting VA does not appear to be predictive of visual or anatomic outcome. As a significant number of patients with good vision at presentation develop legal blindness, therapeutic intervention during periods of visual decline may be considered in these patients.
From Associated Retinal Consultants P.C., William Beaumont Hospital, Royal Oak, Mich. Drs Recchia and Carvalho-Recchia are currently affiliated with the Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tenn. The authors have no relevant financial interest in this article.
|
