Abstract
Purpose :
There is limited knowledge regarding co-occurrence of age-related macular degeneration (ARMD) and central retinal vein occlusion (CRVO). Through this retrospective observational study, we aim to determine the prevalence of exudative ARMD (exAMD) in eyes with CRVO and compare it to the one in the uninvolved fellow eye.
Methods :
Using the Research Patient Data Registry (RPDR), we reviewed 1780 patient records from Massachusetts Eye and Ear over 15 years (2008-2023) with CRVO, accounting for laterality X (ICD-10 code: H34.81X). We selected eyes with either non-exudative ARMD (ICD-10 code: H35.31X) or exudative ARMD (ICD-10 code: H35.32X), while requiring diagnoses and visit codes to appear at least twice for better search accuracy. Eyes with concurrent artery occlusion and choroidal neovascularization (CNV) unrelated to ARMD were excluded. We further characterized eyes with simultaneous active CRVO and exAMD by looking at trends in visual acuity and anti-vascular endothelial growth factor (VEGF) injection frequency.
Results :
Among CRVO patients, 2.4% (n=43) had non-exudative ARMD, with 0.7% (n=12) in the eye with CRVO and 1.7% (n=31) in the fellow eye. One point five percent of patients (n=27) had exudative ARMD; 0.4% (n=6) had it in the eye with CRVO and 1.1% (n=20) in the fellow eye. Of the 6 patients who had eyes with concurrently active CRVO and exAMD, 3 had evidence of active exAMD prior to CRVO and 3 had it afterwards. All these patients also had exAMD develop at some point in the fellow eye. The 3 eyes that had exAMD before CRVO developed CRVO 40, 86 and 21 months after exAMD onset and 21, 25 and 6 weeks after their last injection of anti-VEGF, respectively. The 3 eyes that developed exAMD after CRVO did so 55, 50 and 64 months post-CRVO and 12, 170 and 8 weeks after their last injection of anti-VEGF, respectively. Visual acuity trended down after co-occurrence of both diseases. Injection frequency only increased in eyes with CRVO and subsequent exAMD, after evidence of the latter.
Conclusions :
In this database, the prevalence of exAMD in eyes with CRVO is rare and lower than in the uninvolved fellow eye. This may be due to difficulty in diagnosing exAMD in the presence of CRVO pathology or because CRVO possibly alters the risk of exAMD development, which warrants further investigation.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.