Abstract
Abstract: :
Purpose: To test predictors for the outcome of visual acuity and iris rubeosis in patients with Central Retinal Vein Occlusion (CRVO) and to create a decision model for treatment. The predictors that were considered were: Age, duration of CRVO, visual acuity (VA) and co–morbidity such as glaucoma, previous retinal vein occlusion, cardiovascular disease, diabetes and rheumatoid arthritis (RA) recorded at first visit. Methods: Retrospective data on patients, n = 479, with a debut of CRVO Jan. 1999 unto Jan. 2003, Västra Götaland County, Sweden a source population of 1.5 million. The patients were followed for one year. The predictions were based on a logistic regression model. Results: At first visit, VA of 0.1 or less was recorded in 56.9% (n=247), 0.1< VA < 0.5 in 26.5% (n= 115) and 0.5 or better in 16.6% (n= 72). VA improved among 10% (n=25/247) in the first group, among 17.4% (n= 20/115) in the second group and 48.6% (n=35/72) remained in the third group. Prediction of decreased VA based on VA at first visit was neither possible in women nor in men. Age, duration of CRVO and co–morbidity such as glaucoma, previous retinal vein occlusion, cardiovascular disease, diabetes and rheumatoid arthritis (RA) were associated with the visual outcome. However, logistic regression analysis showed that age was the best predictor followed by cardiovascular disease in women and glaucoma and diabetes in men. Iris–Angle new vessels ± secondary glaucoma developed in 42% of the patients. VA was 0.1 or less in 98% of these patients. Useful predictors were age and VA for both sexes. Conclusions: Age was the best predictor of visual outcome added by cardiovascular disease in women and for men by glaucoma and diabetes. Age and VA were the best predictors of Iris–Angle new vessels ± secondary glaucoma in both sexes. A decision model for treatment is proposed.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications • neovascularization • visual acuity