Abstract
Purpose :
Central retinal vein occlusion (CRVO) is one of the most common retinal vascular diseases in the aging population, but our current understanding of CRVO in the younger population is limited. The purpose of this study is to investigate presenting clinical characteristics, risk factors, clinical progress, and risk factors associated with poor visual outcomes in young CRVO patients.
Methods :
This retrospective study consecutively included patients diagnosed with treatment naïve CRVO between January 2010 and December 2016. Basic demographics, predisposing factors for CRVO, and clinical and ocular parameters at initial and during follow-up periods were reviewed using medical records. We investigated the characteristics of young patients (age<50) with CRVO by comparisons to older patients (age≥50). Those who had more than 6 months follow-up period were included in the final follow-up analysis.
Results :
Sixty-nine patients younger than 50 years and 194 patients aged 50 years and older at the time of CRVO onset were included. At initial visit, younger patients had better acuity (0.41±0.48 vs. 0.80±0.73, logMAR, P<0.001), had less incidence of subretinal fluid (SRF) (39.1 vs. 67.0%, P<0.001), cystoid macular edema (CME) (58.0 vs. 84.8%, P<0.001), and more incidence of paracentral acute middle maculopathy (PAMM) (28.0 vs. 4.7%, P<0.001) than older patients. Younger patients had risk factors such as emotional or physiological stress (14.5 vs. 6.2%, P = 0.032) and hematologic abnormalities (18.8 vs. 2.6%, P=0.003). Older patients had risk factors such as hypertension (13.0 vs. 52.6%, P<0.001) and pulmonary disease (5.7 vs. 0%, P=0.043). At final follow-up, younger patients had better acuity (0.37±0.57 vs. 0.93±1.02, logMAR, P<0.001), less incidence of SRF (0 vs. 15.3%, P=0.004) and CME (8.2 vs. 35.2%, P<0.001). Regression analysis showed age (P=0.028), male gender (P=0.034), coexisting renal disease (P=0.050), and baseline acuity (P=0.002) to be associated with poor prognosis of less than 20/30 acuity in younger CRVO patients.
Conclusions :
Younger patients had a better baseline and final acuities, a lower incidence of CME and SRF, and higher incidence of PAMM. They also showed nontraditional risk factors. These results suggest a better prognosis of younger patients in CRVO, but those with old age, male gender, the presence of renal disease, and poor baseline acuity may have a poor prognosis.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.