Baseline clinical features predict visual outcome in young patients with central retinal vein occlusion

Graefes Arch Clin Exp Ophthalmol. 2020 Jul;258(7):1367-1377. doi: 10.1007/s00417-020-04679-8. Epub 2020 Apr 12.

Abstract

Purpose: To evaluate prognostic factors in young patients with central retinal vein occlusion (CRVO).

Methods: Retrospective case series. CRVO patients aged ≤ 50 and follow-up ≥ 6 months were enrolled. The best corrected visual acuity (BCVA) and central retinal thickness (CRT) at baseline, 3 months, 6 months, and last visit were documented. Severity of retinopathy was graded by comparing to standard photos. Prognostic factors associated with visual outcome at 6 months were evaluated by multiple linear regression models.

Results: A total of 73 eyes from 69 patients with mean age 37.6 ± 8.5 were enrolled. Forty-seven (68%) patients were male. The mean follow-up duration was 25.9 ± 23.0 months. LogMAR BCVA improved from 0.979 ± 0.785 at baseline to 0.594 ± 0.748 at the 6 months (p < 0.001) and CRT improved from 475 ± 222 μm to 299 ± 104 μm (p < 0.001). Forty-eight (66%) eyes required anti-vascular endothelial growth factor (anti-VEGF) treatment. The mean number of injections was 2.25 ± 1.41 in the first 6 months and 75% of eyes received ≦ 3 injections during the clinical course. The baseline BCVA (coefficient 0.518, p < 0.001), grade of retinal hemorrhage (coefficient 0.230, p = 0.006), grade of retinal venous engorgement (coefficient 0.238, p = 0.011), grade of optic disc edema (coefficient - 0.226, p = 0.005), and diabetes mellitus (coefficient 0.264, p = 0.047) were the independent factors associated with visual outcome at 6 months.

Conclusions: Baseline clinical features are useful for the prediction of visual outcome at 6 months in young CRVO patients.

Keywords: Anti-vascular endothelial growth factor; Central retinal vein occlusion; Retinal hemorrhage; Venous engorgement; Young.

MeSH terms

  • Adolescent
  • Adult
  • Angiogenesis Inhibitors / administration & dosage*
  • Female
  • Fluorescein Angiography / methods*
  • Follow-Up Studies
  • Fundus Oculi
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Retina / pathology*
  • Retinal Vein Occlusion / diagnosis*
  • Retinal Vein Occlusion / drug therapy
  • Retinal Vein Occlusion / physiopathology
  • Retrospective Studies
  • Time Factors
  • Tomography, Optical Coherence / methods*
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity*
  • Young Adult

Substances

  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A