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Diana Leitner, Akshay Thomas, Sharon Fekrat; Bilateral Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1548.
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© ARVO (1962-2015); The Authors (2016-present)
Retinal vein occlusion (RVO) is bilateral in about 10% of cases. We compare risk factors and clinical outcomes in persons with central retinal vein occlusion (CRVO) in one eye and any RVO in the fellow eye versus those with unilateral CRVO.
A retrospective observational study identified persons with CRVO in one eye seen at our institution. The following data were collected: demographic factors, traditional RVO risk factors, work-up for secondary causes, time to involvement of the fellow eye, treatment, and outcomes. Individuals with unilateral CRVO (Group 1) were compared to those with CRVO in one eye and any RVO in the fellow eye (Group 2).
We identified 245 persons with CRVO in one eye. Of these, 19 (7.8%) had an RVO in the second eye, including 10 (53%) with bilateral CRVO, 2 (11%) with a hemiretinal vein occlusion (HRVO), and 7 (37%) with a branch retinal vein occlusion (BRVO). Compared to those with a unilateral CRVO, persons with bilateral RVO had no significant difference in rates of risk factors, such as hypertension, diabetes, or smoking, or in use of aspirin or other blood thinners. Persons with bilateral RVO were significantly more likely to be prescribed oral pentoxifylline (p=0.027). There was no significant difference in presenting visual acuity in the CRVO eye between the two groups. Persons with bilateral RVOs received significantly fewer injections in the 1 year after diagnosis of CRVO (p=0.002) and at final follow-up (p=0.002). There was no significant difference in outcomes at last follow-up visit including visual acuity, presence of macular edema, or central macular thickness. No one had the simultaneous onset of bilateral RVO. There was a wide variation in time to involvement of the fellow eye; ranging from 2 weeks to 39 years. In 32%, work-up revealed other ocular or systemic causes that may have contributed to the bilaterality of the RVO.
Our study found 7.8% of persons with CRVO in the one eye also had any RVO in the fellow eye, consistent with previously published prevalence rates of bilateral RVO. Persons with a CRVO in one eye and any RVO in the fellow eye have an increased likelihood of an underlying etiology. There was a wide variation in time to second eye involvement.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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