June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Central Retinal Vein Occlusion in Younger Patients: Causes, Presentation and Outcomes
Author Affiliations & Notes
  • Kirin Khan
    Duke University, Durham, North Carolina, United States
  • Akshay Thomas
    Duke University, Durham, North Carolina, United States
  • Adam Rothman
    Duke University, Durham, North Carolina, United States
  • Sharon Fekrat
    Duke University, Durham, North Carolina, United States
  • Footnotes
    Commercial Relationships   Kirin Khan, None; Akshay Thomas, None; Adam Rothman, None; Sharon Fekrat, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3652. doi:
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      Kirin Khan, Akshay Thomas, Adam Rothman, Sharon Fekrat; Central Retinal Vein Occlusion in Younger Patients: Causes, Presentation and Outcomes. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3652.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : To evaluate the causes and clinical outcomes in younger patients with central retinal vein occlusion (CRVO).

Methods : In this single center retrospective study, we examined the medical records of all patients presenting with CRVO between January 2009 and July 2016. Risk factors for those presenting with CRVO under the age of 50 years were examined. Presentation, OCT parameters and visual outcomes for those <50 years of age vs. those 50 years of age and greater were assessed with comparative statistics.

Results : 247 eyes of 247 patients were included in this study. 27 of these patients (11%) were younger (<50 years old) at CRVO onset. 14/27 (52%) had traditional risk factors for CRVO such as hypertension, diabetes, smoking, hyperlipidemia or glaucoma. Workup for additional risk factors for CRVO was performed on 21 of these 27 CRVO patients. Additional risk factors for CRVO identified were oral contraceptive use (2 patients), mutations for Factor V Leiden (3 patients), retinal vasculitis (2 patients), elevated homocysteine (1 patient) and pregnancy (1 patient). Two of the 27 patients developed CRVO within 12 hours of intense aerobic exercise. Five younger patients had neither traditional nor additional identified risk factors for CRVO. There was a trend for the younger sub-group to have a higher frequency of non-ischemic CRVO than the older sub-group (67% vs 40%, p=0.058). Younger patients with CRVO had better presenting and final logMAR acuity than the older sub-group (0.43 vs 1.04, p<0.001; 0.58 vs 1.17, p=0.003 respectively). Presenting central macular thickness (CMT) on OCT was lower in those < 50 years old (368.3 microns vs. 545.6 microns, p=0.008) but was similar between the groups at final follow-up (299.8 microns vs. 359.5 microns, p=0.672). Additionally, younger CRVO patients were less likely to have cystoid macular edema (CME) at baseline (52% vs 84%, p=0.01).

Conclusions : CRVO can occur in persons less than 50 years old without traditional risk factors. Workup is often unrevealing but may uncover an underlying coagulopathy. CRVO is more often non-ischemic and visual outcomes tend to be better in younger patients with CRVO.

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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