PROGNOSTIC FACTORS FOR RETINAL VEIN OCCLUSION - A PROSPECTIVE-STUDY OF 175 CASES

Background: The prognosis of retinal vein occlusion is highly unpredic table because nonischemic types may convert into ischemic types within the first months. This study was designed to identify epidemiologic c haracteristics of the different types of retinal vein occlusion, their visual outcome, and their prognostic factors. Methods: The authors an alyzed prospectively the data from patients who have had retinal vein occlusion with complete medical and biologic examination, including fl uorescein angiography, and a 1-year follow-up. Results: One hundred se venty-five retinal vein occlusion eyes consisted of 120 central retina l vein occlusions (CRVO), 7 hemicentral occlusions, and 48 branch occl usions. In initially nonischemic CRVO eyes, retinal ischemia developed in 54%. The study of prognostic factors in the CRVO group showed that older age, male sex, and the number of risk factors (systemic vascula r risk factors and glaucoma) were correlated with a poor visual outcom e and with the development of retinal ischemia, as well as baseline vi sual acuity, initial extent of retinal ischemia, and theologic finding s (hematocrit, fibrinogen, and erythrocyte aggregation levels). Logist ic regression underlined the prognostic role of sex, the number of ris k factors, erythrocyte aggregation, and initial clinical features. Per sistent macular edema was shown to be associated with hyperlipidemia a nd cardiovascular history, and inversely correlated to glaucoma. Concl usion: Because clinical characteristics of CRVO may worsen, the author s' results provide a basis to predict visual outcome by taking into ac count epidemiologic and theologic findings. A careful follow-up of the se patients is recommended.