ABSTRACT
OBJECTIVE: To investigate the visual prognosis in perfused (nonischemic) central retinal vein occlusion (CRVO), to determine the frequency of conversion from perfused to nonperfused CRVO, and to identify risk factors for poor visual outcome. DESIGN: Case series. SETTING: Retina referral centre in Portland, Ore. PATIENTS: Fifty-eight patients (59 eyes) with perfused CRVO followed for at least 1 year (average 2.5 years). MAIN OUTCOME MEASURES: Visual acuity, progression to nonperfused CRVO. RESULTS: At the final follow-up visit the visual acuity had improved by two or more lines in 9 eyes (15%), remained the same in 33 eyes (56%) and decreased by two or more lines in 17 eyes (29%). Factors significantly related to visual outcome were initial visual acuity (p = 0.0001) and age, older patients having a worse visual outcome (p = 0.0029). Nine eyes (15%) progressed to nonperfused CRVO. None of the factors analysed, including age, sex, duration of symptoms and initial visual acuity, were predictive of progression. CONCLUSIONS: Perfused CRVO frequently results in significant, permanent visual loss, and a poor visual outcome is most likely in older patients and those with poor initial visual acuity.
Subject(s)
Retinal Vein Occlusion/etiology , Visual Acuity/physiology , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Middle Aged , Perfusion , Prognosis , Retinal Vein Occlusion/physiopathology , Retrospective Studies , Risk Factors , Vision, Ocular/physiologyABSTRACT
Parafoveal telangiectasia is a microvascular abnormality of the macula that may be developmental or acquired. Twenty-eight patients with this condition and normal fasting blood glucose levels underwent ophthalmologic evaluation and glucose tolerance testing. Bilateral telangiectasia was more frequently associated with laboratory evidence of abnormal glucose metabolism than unilateral disease (five of eight cases vs six of 17 cases). In five of our patients, results of glucose tolerance testing were consistent with diabetes even though fasting blood glucose levels were normal. Right-angle venules, which have been reported to be an important sign of bilateral disease, were also found in unilateral telangiectasia. Unilateral telangiectasia occurs in females as well as males. Glucose tolerance testing should be performed in all patients who have bilateral parafoveal telangiectasia.
