Objective-To investigate systematically the natural history of visual outcome in branch retinal artery occlusion (BRAO).
Design-Cohort study.Participants-199 consecutive untreated patients (212 eyes) with BRAO, first seen in our clinic from 1973 to 2000.Methods-At first visit, all patients had a detailed ophthalmic and medical history, and comprehensive ophthalmic evaluation. Visual evaluation was done by recording visual acuity, using the Snellen visual acuity chart, and visual fields with a Goldmann perimeter. The same ophthalmic evaluation was performed at each follow-up visit.
Main Outcome Measures-Visual acuity and visual fields.Results-BRAO was classified into permanent (133 eyes) and transient (18 eyes) BRAO and cilioretinal artery occlusion (CLRAO -61 eyes). In eyes with permanent BRAO, of the 61 eyes seen within 7 days of onset, initial visual acuity was 20/40 or better in 74%, central scotoma in 20%, central inferior altitudinal defect in 13%, and inferior nasal and superior sector defects in 29% and 24% respectively. Of those with follow-up, in the eyes with visual acuity worse than 20/40, it improved in 79% (11 of 14), abnormal central visual field defect improved in 47%, and abnormal peripheral visual field defect improved in 52%. Of the 18 eyes with transient BRAO, initially 17 (94%) had visual acuity of 20/40 or better and one (6%) worse that 20/40, which improved to 20/30 on follow-up. Of the 11 eyes with nonarteritic CLRAO alone, visual acuity was worse than 20/40 in 3 eyes -that improved to 20/40 or better in all during follow-up. In CLRAO on follow-up of 9 eyes, the central field improved in 4. When CLRAO was associated with retinal vein occlusion (38 eyes) or giant cell arteritis (12 eyes), visual findings were influenced by the associated diseases. Correspondence to: Dr. S.S. Hayreh, Department of Ophthalmology and Visual Sciences, University Hospitals & Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242-1091, Telephone No. 319-356-2947.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.This article contains online-only material. The following should appear online-only: Tables 2,4,5 and 7."The authors have no conflict of interest.
NIH Public Access
Author ManuscriptOphthalmology. Author manuscript; available in PMC 2010 June 1. Conclusion-These findings show that visual acuity of 20/40 or better is seen initially in 74% of permanent BRAO, 94% of transient BRAO and 73% of nonarteritic CLRAO alone; and finally on follow-up, in 89%, 100% and 100% respectively. The effectiveness of various treatment modalities for visual outcome has to be judged ...