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J Kono Kono, A Wegner, IM Lanzl; Central Retinal Vein Occlusion: Follow-Up in Patients With and Without Glaucoma . Invest. Ophthalmol. Vis. Sci. 2002;43(13):497.
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Purpose: Primary open angle glaucoma (POAG) might be a risk factor for central retinal vein occlusion (CRVO), a disease with impaired visual prognosis. Primary aim of our study was to characterize the change of visual acuity in eyes with glaucoma before and after CRVO. Secondary aim was to assess the frequency of optic nerve head (ONH) neovascularisation (NV) and iris NV in eyes with and without POAG after CRVO considering the occlusion type. Methods: 19 patients (19 eyes) with a history of glaucoma (12 POAG, 6 PEX glaucoma and one chronic angle closure glaucoma) and newly diagnosed CRVO were retrospectively evaluated (group 1). The control group consisted of 22 patients without glaucoma (group 2). Observation period ranged from 12-31 months. Main outcome measures were the change of visual acuity before and after CRVO, ONH and / or iris NV on fluorescein angiography or slit lamp ophthalmoscopy within the observation period. Results: The groups were significantly different in age (72.4 7.3 years group 1 and 65.4 13 years in group 2; p = 0.03, t-test). 10 of 19 eyes in the glaucoma group and 4 of 22 in the control group achieved a visual acuity of 1/25 or less after CRVO (p = 0.02). Compared to eyes without glaucoma, the glaucoma affected eyes developed significantly more ischemic CRVO (p = 0.008). Iris NV were significantly more frequent in ischemic CRVO than in the non-ischemic type (p 0.05). Conclusion: Glaucoma patients have a significantly higher rate of the ischemic type of CRVO than non-glaucoma patients. The risk of severe visual acuity loss is statically higher in glaucoma eyes compared to non-glaucoma eyes after CRVO. Iris NV is more frequent after ischemic CRVO compared to the non-ischemic type. Whether preexisting glaucoma represent a risk factor for the development of iris or ONH NV can not be elucidated by our study alone. A trial with larger patient numbers is required to answer this question.
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