THE RISK OF MISSING ANGLE NEOVASCULARIZATION BY OMITTING SCREENING GONIOSCOPY IN ACUTE CENTRAL RETINAL VEIN OCCLUSION

Objective: The purpose of the study was to determine whether angle neo vascularization can occur without pupillary margin neovascularization in central retinal vein occlusion (CRVO). Design: The study design was a prospective study of the main question and a retrospective study of ancillary issues. Participants: The authors examined 105 eyes of 100 patients with CRVO having clinical evidence of ischemia between July 1 , 1986, and March 18, 1996. Intervention: The authors looked for iris and angle neovascularization with both undilated slit-lamp biomicrosco py and Zeiss four-mirror gonioscopy. Main Outcome Measures: The presen ce of anterior segment neovascularization was measured. Results: Of 34 eyes developing anterior segment neovascularization, 4 (12%) develope d angle neovascularization without pupillary margin neovascularization over a mean follow-up of 2.2 +/- 2.4 standard deviation years. Conclu sions: Angle neovascularization can occur without pupillary margin inv olvement in CRVO, implying the necessity of screening gonioscopy and s upporting the Central Vein Occlusion Study conclusion (based on a phot ographic technique not used clinically).