The Relationship of Retinal Vein Occlusion and Open Angle Glaucoma

Abstract

Purpose : Our study seeks to understand the relationship between open-angle glaucoma (OAG) and retinal vein occlusion (RVO) by comparing characteristics of patients who developed OAG before versus after an RVO.

Methods : We performed a retrospective, cross-sectional study of patients with OAG and RVO who were identified using billing records from 2015 to 2022. The chronological order of diagnoses was determined through a comprehensive review of medical records. Patients were stratified based on the sequence of diagnoses—those with RVO preceding OAG and vice versa. Demographic, clinical characteristics, and results from Humphrey visual field (HVF) testing and retinal nerve fiber layer (RNFL) imaging were assessed. For patients initially presenting with OAG, eyes later developing RVO were compared with fellow eyes to identify differences in examination and testing characteristics.

Results : In this study, 78 eyes with OAG that subsequently developed RVO were compared with 51 eyes with RVO that later developed OAG. Eyes developing OAG after RVO were found to be younger at the time of RVO compared to those with OAG followed by RVO (69.3 ± 3.5 vs. 80.4 ± 2.1 years, p=0.005, Figure 1A). No significant differences were observed in visual acuity (VA; 0.72 ± 0.15 vs. 0.63 ± 0.21 LogMAR, p=0.508) or intraocular pressure (IOP; 19.5 ± 1.5 vs. 18.9 ± 1.5 mmHg, p=0.591). However, the cup-to-disc ratio (CDR) was larger in eyes with OAG first. Interestingly, a preceding RVO did not influence the age at the time of OAG diagnosis (74.8 ± 2.1 vs. 74.8 ± 3.1 years, p=0.962, Figure 1B). The time elapsed between the diagnoses of OAG and RVO versus RVO and OAG showed no significant difference (5.60 ± 0.99 vs. 5.54 ± 1.71 years, p=0.948, Figure 1C).

Conclusions : In patients with OAG, no clear exam or functional characteristics differentiate eyes that go on to sustain a future RVO. While RVO is known to increase risk of future OAG, there are no differences in vision loss at the time of vein occlusion. Additionally, preceding RVO does not appear to affect age at the time of OAG diagnosis.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Figure 1. Log-rank tests comparing the age of patients at the time of OAG diagnosis, with RVO occurring either before or after OAG diagnosis (A; p<0.001, 𝛘²=26.9, df=1). A similar comparison is presented for age at RVO diagnosis (B; p=0.328, 𝛘²=0.974, df=1), along with the assessment of the time interval between the two diagnoses (C; p=0.968, 𝛘²=0.002, df=1).