Clinical features in Japanese patients of central retinal vein occlusion (CRVO) complicated with normal-tension glaucoma (NTG) – A retrospective study

Session Details

Session Title: Free Paper Session 7: Vascular Diseases & Diabetic Retinopathy II

Session Date/Time: Thursday 07/09/2017 | 14:30-16:00

Paper Time: 15:18

Venue: Room 117

First Author: : T.Kida JAPAN

Co Author(s): :    M. Fukumoto   T. Sato   H. Oku   T. Ikeda                    

Abstract Details

Purpose:

The association of central retinal vein occlusion (CRVO) with primary open-angle glaucoma (POAG) or ocular hypertension has been reported, and lowering intraocular pressure (IOP) helps improve retinal circulation in an eye with CRVO. However, the clinical features in CRVOs with normal-tension glaucoma (NTG) are not well-known. Therefore, we investigated Japanese CRVOs with NTG.

Setting:

A retrospective study reviewed at Department of Ophthalmology, Osaka Medical College Hospital

Methods:

We investigated 234 patients with CRVO retrospectively (January 2011 - December 2015), with follow-ups of more than 12 months, and evaluated the prevalence of glaucoma in patients with CRVO. Then, in patients with NTG or POAG, the fluctuation of intraocular pressure (IOP), visual acuity (VA), optic disc findings (vertical C/D ratio; cup-disc ratio), and treatments were examined.

Results:

Forty-four (18.8%) patients had glaucoma in 234 patients with CRVO; 20 patients with neovascular glaucoma, 18 NTG or POAG, 4 secondary glaucoma, and 2 primary angle closure glaucoma. In this retrospective study, we report that 18 (7.7%) patients were diagnosed with NTG or POAG. There were 12 nonischaemic and 6 ischaemic CRVOs. The mean C/D ratio was 0.8. The mean age of the 10 NTG patients was 72.4 ± 10.6 years, and 74.1 ± 10.0 years for the 8 POAG patients. The mean follow-up was 35.8 ± 21.7 months for POAGs and 28.3 ± 24.0 months for NTGs. Seven POAGs (87.5%) and three NTGs (30%) had systemic hypertension. In the 10 NTGs, 5 (50%) had dyslipidemia, 3 (30%) had systemic hypertension, 2 had chronic renal failure requiring dialysis, 1 had angina pectoris, and 1 had diabetes mellitus without retinopathy. The mean VA (logMAR) of NTG patients was significantly improved from 0.7 ± 0.4 at the initial CRVO evaluation to 0.4 ± 0.5 at the final visit (P = 0.0067). At the initial CRVO evaluation, 6 NTGs showed the significantly increased IOP; mean IOP was 13.3 before CRVO, 16.2 at CRVO, and 13.5 mmHg at the final visit.

Conclusions:

The proportion of NTGs with systemic hypertension was low. NTG patients’ IOPs were significantly elevated at the initial CRVO evaluation, even in the presence of anti-glaucoma drugs.

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