First Author: S.SAHA INDIA
Co Author(s): 0 0 0 0 0 0 0 0 0
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To analyse the visual outcome of CRVO patients and identify the the various epidemiological,clinical and therapeutic factors associated with such outcome.
Study was conducted on CRVO patients attending a tertiary care eye hospital in West Bengal, India.
This retrospective study of 84 patients of CRVO seen over a period of 8 years, analyses the visual acuity outcome of the patients and correlate with the epidemiological, clinical, and therapeutic factors associated in each patient. Patients with follow-up of at least 6 months were included in the study. The visual acuity of the patients were correlated with the following variables (a) Age of the patient (b) Sex of the patient (c) Associated systemic and ocular diseases (d) Duration of onset of visual symptoms (e) Visual acuity at presentation (f) Central Macular Thickness (CMT) measured in OCT (g) Digital fundus angiographic (DFA) features (h) Therapeutic interventions performed (intravitreal injections of triamcinolone acetonide or bevacizumab and pan retinal photocoagulation)
Best visual prognosis was noted in males <40 years of age having single systemic or ocular risk factor (systemic hypertension or diabetes or hyperlipidaemia or anaemia or hyperhomocysteinaemia or primary open angle glaucoma ) presenting in OPD (Out Patient Department )within a week of onset of symptoms with presenting vision of 6/18 or better. CMT of <500µ in OCT and absence of macular or peripheral retinal ischaemia in DFA study had best visual outcome. On the contrary worst visual outcome was noted in females >60years having multiple systemic and ocular risk factors reporting in OPD 2 months after the onset of symptoms with presenting visual acuity of 6/24 or worse. CMT>800µ in OCT and presence of macular ischaemia or retinal neovascularization in DFA study were associated with worst visual prognosis.
CRVO is classified mainly into non-ischaemic and ischaemic types based on clinical and angiographic criteria to understand the prognosis and plan proper management. Non-ischaemic type has favorable visual prognosis while ischaemic type has poor visual outcome. A sub-group of non-ischaemic type (called indeterminate type) may change to ischaemic type over a period of 6-12 months. This retrospective study tries to identify which patients with CRVO will have non-ischaemic course with favorable visual outcome and who are likely to have ischaemic course with poor visual outcome. Management of CRVO patients remain a challenging proposition to the clinician. Categorization of patient according to above variables will help to identify which patient is likely to improve with minimum intervention and who needs maximum of the clinician’s efforts.