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A. Glacet-Bernard, J. Tilleul, G. J. Coscas, G. Soubrane, E. H. Souied; Underlying Conditions Associated to the Occurrence of Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3543.
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Conventional risk factors for retinal vein occlusion (RVO) are well established through large epidemiologic studies, but some associated conditions are not totally considered.
Prospective observational study. Patients with RVO were compared to age- and sex- matched control through a questionnaire fulfilled between January and October 2009. Controls were recruited among healthy patients who underwent cataract surgery.
61 patients, including 42 central retinal vein occlusions (CRVO) and 19 branch vein occlusions (BRVO), and 118 controls were included. Patients and controls were similar for age and gender. Out of the CRVO patients, 77% discovered visual loss upon awakening in contrast to 33% of BRVO patients. The onset of RVO was regularly distributed throughout the year, with a slight predominance for the months of May, September, October and December. The comparison between RVO and controls displayed a higher proportion in the RVO group for (in order of the higher risk): migraine headache (CRVO: 21%, BRVO: 47%, controls: 13%, p=0.008), hypertension (CRVO: 52%, BRVO: 63%, controls: 37%, p=0.012), glaucoma (CRVO: 33%, BRVO: 22%, controls: 16%, p=0.034), antiaggregant or anticoagulant medication (CRVO: 42%, BRVO=33%, controls: 26%, p=0.074), hyperlipidemia, ocular traumatism, sudden deafness or vertigo. The prevalence was similar in both groups for: body mass index, history of phlebitis or peptic ulcer, smoking habits, stress, fasting, dehydration, vasodilator intake (such as phosphodiesterase inhibitor erectile dysfunction drugs), altitude stay.
In addition to the already known risk factors, this study underlines some underlying conditions or circumstances to the onset of RVO, such as migraine. In CRVO, ¾ of the patients in average discovered visual loss upon awakening, which may indicate that nocturnal events may play a significant role in the pathogenesis of the occlusion. Conversely, the possible role of stress or dehydration or vasodilators is not confirmed.
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