July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Gender differences in presentation, treatment patterns, and clinical outcomes in central retinal vein occlusion
Author Affiliations & Notes
  • Delaram Mirzania
    Duke University School of Medicine, Durham, North Carolina, United States
  • Akshay S Thomas
    Tennessee Retina, Nashville, Tennessee, United States
  • Sandra S Stinnett
    Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina, United States
  • Sharon Fekrat
    Department of Ophthalmology, Duke Unviersity Medical Center, Durham, North Carolina, United States
  • Footnotes
    Commercial Relationships   Delaram Mirzania, None; Akshay Thomas, None; Sandra Stinnett, None; Sharon Fekrat, Alcon (P), Regeneron (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3943. doi:https://doi.org/
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      Delaram Mirzania, Akshay S Thomas, Sandra S Stinnett, Sharon Fekrat; Gender differences in presentation, treatment patterns, and clinical outcomes in central retinal vein occlusion. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3943. doi: https://doi.org/.

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

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Abstract

Purpose : To evaluate the impact of gender on the presenting features, treatment patterns, and clinical outcomes in patients with central retinal vein occlusion (CRVO).

Methods : This single-center retrospective longitudinal cohort study included all adult subjects diagnosed with CRVO over a seven-year period (2009-2016). Charts were reviewed and clinical data abstracted. Clinical parameters and treatment patterns were compared between males and females over the course of follow-up.

Results : We identified 476 patients with CRVO, 224 (47%) of which were male. The average age at CRVO onset was significantly lower in males compared to females (63.8 vs 66.1 years, p= 0.048). Gender was not significantly associated with known systemic risk factors for CRVO (hypertension, diabetes, and open angle glaucoma; p>0.05). However, in subjects with available smoker status data, a greater proportion of current smokers were men (46/73, 63% vs 27/73, 37%; p=0.002). Men and women had similar baseline and final visual acuity and rates of neovascular sequelae. However, a significantly larger proportion (n/N) of males (104/224, 54%) had an ischemic CRVO compared to females (113/252, 45%) over the first year of follow-up (p=0.05). Men with CRVO had a greater central subfield thickness (CST) (546.7±306.8 mm vs 438.4±252.9 mm, p= 0.003) and subfoveal choroidal thickness (SCT) (262±99.6mm vs 230.4±83.11mm, p= 0.048) at baseline compared to women. CST was also significantly greater in men at the final visit (343±179.5mm vs 304.6±176.2mm, p=0.005) but the change in CST was similar over the course of follow-up between the groups. Among those with baseline FA, foveal avascular zone (FAZ) enlargement was significantly more common in males (39/102, 38%) vs females (29/116, 25%) at baseline (p= 0.042). Treatment patterns and treatment burden were similar between genders.

Conclusions : Gender differences are present in persons with CRVO, specifically regarding perfusion status, CST, SCT, and prevalence of FAZ enlargement. Men with CRVO were also more likely to be active smokers than females with CRVO. However, visual outcomes and treatment burden were similar between the groups. Further study may provide individualized recommendations for treatment and follow-up of CRVO based on gender.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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