Natural History of Central Retinal Vein Occlusion: An Evidence-Based Systematic Review

McIntosh, Rachel; Rogers, Sophie; Lim, Lyndell L; Cheung, Ning; Wang, Jie Jin; Mitchell, Paul; Kowalski, Jonathan W.; Nguyen, Hannah; Wong, Tien Yin

doi:10.1016/j.ophtha.2010.01.060

Cited by 432 publications

(326 citation statements)

References 67 publications

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“…Its prevalence changes according to studies in overall populations are from 5.2 to 16 per 1,000 [1][2][3][4] . People with end-organ damage caused by diabetes mellitus and hypertension have strongly increased risk for RVO.…”

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confidence: 99%

“…The majority of individual diagnosed with RVO defined more than one component of the systemic vascular and metabolic disease, such as the presence of Diabetes Mellitus, hyper tension and high serum lipids. Coexisting metabolic diseases are important factors for prognosis and laser treatment response [1][2][3][4][5] .There are mainly two types of RVO according to occlusion side branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). In BRVO occlusion is located in the any branch of the retinal vein system, while occlusion located exactly in the central retinal vein in CRVO.…”

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confidence: 99%

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confidence: 99%

“…Different researches shows that BRVO is 4-6 times more common than CRVO and it has been estimated that there are around 80 new cases of CRVO/million population/ year. Although CRVO most commonly affects one eye, in around 10% of patients the disease affects both eyes [2][3][4][5][6][7] . Even RVO was first recognized over a century ago, the exact pathogenesis is not completely nderstood and therefore exact treatment methods not found yet.…”

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confidence: 99%

“…In non-ischemic types of CRVO subsequent neovascular glaucoma is rare. Therefore panretinal or scatter laser photocoagulation (PRPC) in non-ischemic CRVO is not necessary [2,3,18,20] .…”

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confidence: 99%

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Laser Photocoagulation in Retinal Vein Occlusion

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2016

International Journal of Ophthalmic Research

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Retinal vein occlusion (RVO) is the second most common retinal vascular disease after diabetic retinopathy which is a frequently devastating cause of blindness in mainly in older patients over 60 years of age. Its prevalence changes according to studies in overall populations are from 5.2 to 16 per 1,000 [1][2][3][4] . People with end-organ damage caused by diabetes mellitus and hypertension have strongly increased risk for RVO. The majority of individual diagnosed with RVO defined more than one component of the systemic vascular and metabolic disease, such as the presence of Diabetes Mellitus, hyper tension and high serum lipids. Coexisting metabolic diseases are important factors for prognosis and laser treatment response [1][2][3][4][5] .There are mainly two types of RVO according to occlusion side branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). In BRVO occlusion is located in the any branch of the retinal vein system, while occlusion located exactly in the central retinal vein in CRVO. Different researches shows that BRVO is 4-6 times more common than CRVO and it has been estimated that there are around 80 new cases of CRVO/million population/ year. Although CRVO most commonly affects one eye, in around 10% of patients the disease affects both eyes [2][3][4][5][6][7] . Even RVO was first recognized over a century ago, the exact pathogenesis is not completely nderstood and therefore exact treatment methods not found yet. The condition may be due to a combination of three systemic changes known as Virchow's triad: (1) hemodynamic changes such as venous stasis; (2) degenerative changes of the vessel wall; and (3) blood hypercoagulability [6,8,9] . According to clinical findings, fundus appearance, Fluorescein angiography and electrophisiological results Hayreh futher divided RVO into three types: (1) BRVO is divided further into major BRVO (a) and macular BRVO (b) according to localization; (2) CRVO is divided into ischemic and non-ischemic types due to presence or absence of ABSTRACTVisual acuity is primarily decreased secondary to macular edema, retinal ischemia and complications of neovascularisation in both BRVO and CRVO. Panretinal Laser photocoagulation or Focal photocoagulation is an effecting treatment for neovascularisation and prevention of complications of neovascularisation by ablating ischemic retina in either BRVO or CRVO. But Macular Laser photocoagulation can be use for treatment of non ischaemic macular oedema in only BRVO either alone or combination with other Anti-VEGF or Anti-inflammatory medication.

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confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

“…In non-ischemic types of CRVO subsequent neovascular glaucoma is rare. Therefore panretinal or scatter laser photocoagulation (PRPC) in non-ischemic CRVO is not necessary [2,3,18,20] .…”

mentioning

confidence: 99%

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Laser Photocoagulation in Retinal Vein Occlusion

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2016

International Journal of Ophthalmic Research

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Branch Retinal Vein Occlusion

2014

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nderstanding the natural history of a disease is fundamental to its management so that treatments are not adopted with apparent benefits that in fact simply represent the natural history of a disease (they may even be harmful). Also, information about natural history acts as the basis to judge the extent of improvement by various therapies. Branch retinal vein occlusion (BRVO) is a common, visually disabling disease. Although BRVO has been known since 1896, 1 there is still conflicting information on its visual outcome. The available data on the natural history of visual outcome in BRVO can be divided into 2 groups: (1) those in which no eye had any treatment 2-8 and (2) the control arm of randomized treatment studies on BRVO, with treated and untreated eyes. 9-19 All these studies have shown visual acuity (VA) improvement without any treatment; however, the incidence, criterion of VA improvement, and study designs vary widely among different studies so that it is impossible to compare their findings. Rogers et al 20 reviewed the natural history of visual outcome in BRVO in articles published in English up to 2010 and concluded that VA generally improved in eyes with BRVO without intervention, although clinically significant improvement beyond 20/40 was uncommon. Branch retinal vein occlusion actually consists of 2 distinct clinical entities: major BRVO and macular BRVO. 21,22 Therefore, we investigated separately for major and macular BRVO the natural history of visual outcome in 216 consecutive untreated eyes (144 eyes with major BRVO and 72 eyes with macular BRVO) that fulfilled our inclusion and exclusion criteria. IMPORTANCE Understanding the natural history of visual outcome in branch retinal vein occlusion (BRVO) is fundamental to its management. OBJECTIVE To investigate the natural history of visual outcome in major and macular BRVO. DESIGN, SETTING, AND PARTICIPANTS Observational cohort study at a university-based referral practice from 1973 until 1999. The study comprised 216 consecutive eyes with BRVO (144 eyes with major and 72 eyes with macular BRVO) seen within 3 months of onset. INTERVENTION At first visit, all patients had a detailed ophthalmic and medical history and comprehensive ophthalmic evaluation. Ophthalmic evaluation at initial and follow-up visits included recording best-corrected visual acuity (VA) using the Snellen VA chart and visual fields with a Goldmann perimeter. MAIN OUTCOMES AND MEASURES Best-corrected VA and visual field outcome on follow-up. RESULTS The median time to macular edema resolution was 21 months in those with major BRVO and 18 months in those with macular BRVO. Overall, for eyes with initial VA of 20/60 or better, VA improved or remained stable in 75% (95% CI, 63%-86%) for major BRVO and 86% (95% CI, 73%-95%) for macular BRVO. In those with initial VA of 20/70 or worse, VA improved in 69% (95% CI, 56%-80%) for major BRVO and in 53% (95% CI, 27%-79%) for macular BRVO, with median final VA of 20/60 for both BRVO types. CONCLUSIONS AND RELEVANCE Major and macular BRVOs...

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Association of Disorganization of Retinal Inner Layers With Visual Acuity Response to Anti–Vascular Endothelial Growth Factor Therapy for Macular Edema Secondary to Retinal Vein Occlusion

et al. 2019

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inner layers (DRIL) has demonstrated significant correlations with visual acuity (VA) in center-involved diabetic macular edema. In patients with retinal vein occlusion (RVO) and secondary macular edema, DRIL may be a useful biomarker in determining VA outcomes. OBJECTIVE To examine whether DRIL at baseline and after treatment is associated with VA in RVO. DESIGN, SETTING, AND PARTICIPANTSA retrospective review of records of 147 patients 18 years or older with treatment-naive branch RVO (BRVO), central RVO (CRVO), or hemispheric RVO (HRVO), with a minimum of 12 months of follow-up, who presented to a tertiary ophthalmic center from December 1, 2010, to January 1, 2016, was conducted. Data collection continued through January 2017. Exclusion criteria included active confounding retinal or ocular disease, history of pars plana vitrectomy, or prior intravitreal injections. Two masked graders calculated a DRIL score based on DRIL presence in 3 predefined regions on spectral-domain optical coherence tomography at baseline, 6 months, and 12 months. A third masked grader was used for discrepancies.EXPOSURES Anti-vascular endothelial growth factor (AVF) therapy (ranibizumab, aflibercept, or bevacizumab) determined by the treating physician. MAIN OUTCOMES AND MEASURESThe DRIL score at baseline for determining VA outcomes and correlation of VA with changes in DRIL burden in response to AVF therapy. RESULTSIn the 147 patients (mean [SD] age, 68.9 [13.1] years; 75 [51.0%] female), baseline DRIL was seen in 91 eyes (61.9%). In the BRVO group but not the CRVO group, baseline DRIL was associated with lower baseline Early Treatment Diabetic Retinopathy Study (ETDRS) score (score of 66.7 for no DRIL vs 54.6 for DRIL, P = .002). Absence of DRIL at baseline in the CRVO/HRVO group correlated with greater VA gains at 6 months, adjusting for baseline VA (score change of 19.50 for no DRIL vs 12.72 for DRIL; P = .04). During 12 months, continued DRIL presence in BRVO was associated with less VA gain up to 6 months (score change of 6.2 for the DRIL increase group vs 18.6 for the DRIL decrease group vs 2.9 for the DRIL stable group; P = .02). Increasing DRIL scores in CRVO/HRVO were associated with reduced VA improvement at 6 months (score change of -0.12 for the DRIL increase group vs 16.90 for the DRIL decrease group vs 8.45 for the DRIL stable group; P = .002) and 12 months (score change of -1.91 for the DRIL increase group vs 17.83 for the DRIL decrease group vs 6.97 for the DRIL stable group; P < .001). CONCLUSIONS AND RELEVANCEBaseline DRIL presence and DRIL burden changes with AVF therapy for macular edema secondary to RVO may be useful biomarkers of ETDRS score improvements.

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Natural History of Central Retinal Vein Occlusion: An Evidence-Based Systematic Review

Cited by 432 publications

References 67 publications

Laser Photocoagulation in Retinal Vein Occlusion

Laser Photocoagulation in Retinal Vein Occlusion

Branch Retinal Vein Occlusion

Association of Disorganization of Retinal Inner Layers With Visual Acuity Response to Anti–Vascular Endothelial Growth Factor Therapy for Macular Edema Secondary to Retinal Vein Occlusion

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