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N. N. Patel, C. E. Song, V. Sarup, K. J. Wald; Relevance of Subretinal Fluid in Central Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2706.
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To investigate the incidence and prognostic significance of subretinal fluid following central retinal vein occlusion.
A retrospective study of 69 eyes (69 patients) diagnosed with central retinal vein occlusion (CRVO) was undertaken. All patients presented within 3 months of symptom-onset, had no neovascular eye disease, and were followed up for a mean of 13.8 months. Detailed ophthalmic examination, optical coherence tomography (OCT) findings and systemic medical conditions were reviewed. Patients with ocular conditions preventing OCT examination were excluded. OCT data from the initial and follow up visits was evaluated in a blind manner by two authors with expertise in interpreting retinal scans to assess if there was evidence of subretinal fluid (SRF), defined as a retinal elevation over a non reflective cavity with minimal shadowing of underlying tissues 1. Patients were divided into two groups: Group [A] where SRF was documented and Group [B] where no SRF was documented. Relationship of SRF to diabetes mellitus (DM), hypertension (HTN), coronary artery disease (CAD) and glaucoma was also assessed.
Thirty-three men and 36 women; age range, 27-96 years (average, 68.2 yrs) constituted the study group. Twenty-nine percent (20/69 eyes) were categorized to group A and 71% (40/69 eyes) to group B. Comparing group A to B, no statistically significant difference was found in the prevalence of HTN 60% (12/20 eyes) vs. 59.2% (29/49eyes), CAD 40.0% (8/20 eyes) vs. 20.4% (10/49 eyes), glaucoma 10% (2/20 eyes) vs. 16.3% (8/49 eyes) or in the mean change of logMAR visual acuities (-) 0.51 vs. (-) 0.44. However, DM was significantly more prevalent in Group B 26.5% (13/49) than Group A 5% (1/20) [p= 0.04].
This study reports a significantly lower incidence of SRF in patients with CRVO than previously reported [29% vs. 82.2%]1. Presence of SRF by itself did not predict a poorer visual prognosis. The incidence of SRF was significantly lower in the diabetic patients but was not influenced by the presence of HTN, CAD, or glaucoma.Reference: (1) Ozdemir H, Karacorlu M, Karacorlu S. Serous macular detachment in central retinal vein occlusion. Retina 25: 561-563, 2005.
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