Abstract
Purpose: :
To assess the visual acuity and rate of complications after combined treatment for central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO).
Methods: :
This study was a retrospective medical records review of 40 eyes of 40 patients (mean age, 66.6 years) that were treated with anticoagulative agents, lasercoagulation, vitrectomy and intravitreal injections of steroids and antiVEGF. Our patients were divided into two groups: those with central retinal vein occlusion (CRVO) and those with branch retinal vein occlusion (BRVO). All patients were subjected to an anamnestic investigation and were tested for thrombophilia, coagulation disorders and hyperlipidemia. The average time between onset of symptoms and first lasercoagulation was 4 months in BRVO and 9 months in CRVO. Vitrectomy was performed in 75 % of eyes with CRVO and 50% of BRVO, intravitreal injections of steroids and antiVEGF were necessary in 50% of all cases.
Results: :
The average loss in visual acuity was 1.3 Snellen lines over the course of the study period. 6 eyes with BRVO gained > or =2 lines of visual acuity, 3 eyes improved 1 line, 3 eyes remained the same, and 4 eyes worsened. One of 21 eyes with CRVO improved in visual acuity. The difference in mean baseline (20/80) and mean final visual acuity (20/128) was statistically significant (P = 0.015). Three of 18 patients without a history of glaucoma developed ocular hypertension and required glaucoma medication during follow-up.
Conclusions: :
CRVO and BRVO are the second most common retinal vein diseases and an important cause of blindness and visual morbidity. Systemic risk factors are commonly associated with both, whereas this role could not be verified in our study. Inspite of some encouraging cases with combined treatment mean visual acuity remains poor also in patients with BRVO. Due to our tight controll regimen no severe complications like malign hypertension, rubeosis iridis or tractional retinal detachment was observed in our study group.
Keywords: vascular occlusion/vascular occlusive disease • laser • vitreoretinal surgery