Macular Ischemia Correlated with Final Visual Outcome in Retinal Vein Occlusion Patients

ABSTRACT

PURPOSE: To identify the correlation between final visual outcome after at least 6 months of follow-up and the extent of macular ischemia on the first visit. METHODS: We performed a retrospective clinical analysis of macular ischemia using clinical records, fundus examinations, and fluorescein angiographies in 83 patients (86 eyes) diagnosed with retinal vein occlusion from January 1998 to July 2012 and followed up for over 6 months. We evaluated the extent and the location of macular ischemia, macular edema, initial and final visual acuities and systemic disease based on fluorescein angiography and optical coherence tomography performed within 2 weeks of the first visit. The patients were divided into the following 4 groups based on the extent and location of macular ischemia and edema superotemporal, superonasal, inferotemporal, and inferonasal. RESULTS: Retinal vein occlusions (RVOs) consisted of 24 central RVOs (CRVOs) and 62 branch RVOs (BRVOs). Mean initial acuity (log MAR) was 0.35 +/- 0.31 (36 eyes) in the no macular ischemia group, 0.40 +/- 0.21 (11 eyes) in the 1-quadrant macular ischemia group, 0.71 +/- 0.32 (26 eyes) in the 2-quadrant macular ischemia group and 0.73 +/- 0.36 (13 eyes) in the over 3 quadrants macular ischemia group. Mean final acuity (log MAR) was 0.23 +/- 0.23 in the no macular ischemia group, 0.40 +/- 0.30 in the 1-quadrant macular ischemia group, 0.51 +/- 0.32 in the 2-quadrant macular ischemic group and 0.73 +/- 0.31 in the over 3 quadrants macular ischemia group. CONCLUSIONS: The initial and final visual outcomes were worse when more quadrants were affected by macular ischemia. The extent of macular ischemia was correlated with initial visual acuity and final visual outcome but not with macular edema.