July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Retinal Vein Occlusion in Young Patients: Risk Factors and Management
Author Affiliations & Notes
  • Jinghua Chen
    Ophthalmology, UT Southwestern Medical Center, Dallas, Texas, United States
  • Brett Mueller II
    Texas Vision & Laser Center, Texas, United States
  • Amir Hadayer
    Ophthalmology, Tel-Aviv University, Israel
  • Shlomit Schaal
    Department of Ophthalmology & Visual Sciences, University of Massachusetts School of Medicine, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Jinghua Chen, None; Brett Mueller II, None; Amir Hadayer, None; Shlomit Schaal, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 4081. doi:
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      Jinghua Chen, Brett Mueller II, Amir Hadayer, Shlomit Schaal; Retinal Vein Occlusion in Young Patients: Risk Factors and Management. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4081.

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

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Abstract

Purpose :
To investigate the various risk factors, characteristics, management and clinical outcomes of retinal vein occlusion (RVO) in patients younger than 45.

Methods :
This is a retrospective case series. Fifteen patients with RVO were identified and data including demographics, history, complete ophthalmic examination, various imaging studies, blood workup, treatment and outcomes were investigated.

Results :
15 patients (7 males, 8 females) with a mean age of 36±7 years (range, 21–45 years) met the inclusion criteria of this study with a mean follow-up time of 10 ±12 months. Central retinal vein occlusion (CRVO) occurred in 11 patients (73%) while branch retinal vein occlusion (BRVO) occurred in 4 patients (37%). In 14 patients (93%) systemic risk factors were identified with the most prevalent systemic risk factors being the ingestion of medications known for causing hyperviscosity or hypercoagulability (33%) states, cardiovascular diseases (26.7%), infection or inflammation (26.7%), intense exercise (20%) and increased platelets count (20%). Eight (53.3%) patients had concomitant eye conditions in addition to the RVO with the most prevalent eye diseases being uveitis in 3 (20%) patients and glaucoma in 2 (13.3%) patients. Vision loss in our RVO patients was typically accompanied with cystoid macular edema (CME) (67%), disc edema (20%) and vitreous hemorrhage (13.3%). None of these 15 patients developed neovascularization. CME in non-ischemic RVO patients was associated with a good visual outcome and the central macular thickness promptly decreased significantly by 163.5±118.8µm (p=0.006) following intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents and visual acuity increased from 20/51±20/77 to 20/34±20/51 (p=0.03).

Conclusions :
This is a case series study to evaluate RVO in the young since the introduction of anti-VEGF therapy. Young patients with CME due to CRVO in our study had more favorable outcomes with fewer intravitreal anti-VEGF injections than reported for older patients. (0.12/month vs 0.5/month). Medications, infection or inflammation, intense exercise and increased platelets count are the unique risk factors in young patients while cardiovascular diseases are the most common risk factors in old patients. More than half of young patients had multiple risk factors. Most risk factors were history related. Non-ischemic RVO was more common than ischemic RVO in our study.

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

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