Branch retinal vein occlusion: natural history of visual outcome

Sohan Singh Hayreh; M Bridget Zimmerman

doi:10.1001/jamaophthalmol.2013.5515

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Branch retinal vein occlusion: natural history of visual outcome

Journal article

Open access

Peer reviewed

Branch retinal vein occlusion: natural history of visual outcome

Sohan Singh Hayreh and M Bridget Zimmerman

JAMA ophthalmology, Vol.132(1), pp.13-22

01/2014

DOI: 10.1001/jamaophthalmol.2013.5515

PMID: 24158729

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Abstract

Understanding the natural history of visual outcome in branch retinal vein occlusion (BRVO) is fundamental to its management. To investigate the natural history of visual outcome in major and macular BRVO. Observational cohort study at a university-based referral practice from 1973 until 1999. The study comprised 216 consecutive eyes with BRVO (144 eyes with major and 72 eyes with macular BRVO) seen within 3 months of onset. At first visit, all patients had a detailed ophthalmic and medical history and comprehensive ophthalmic evaluation. Ophthalmic evaluation at initial and follow-up visits included recording best-corrected visual acuity (VA) using the Snellen VA chart and visual fields with a Goldmann perimeter. Best-corrected VA and visual field outcome on follow-up. The median time to macular edema resolution was 21 months in those with major BRVO and 18 months in those with macular BRVO. Overall, for eyes with initial VA of 20/60 or better, VA improved or remained stable in 75% (95% CI, 63%-86%) for major BRVO and 86% (95% CI, 73%-95%) for macular BRVO. In those with initial VA of 20/70 or worse, VA improved in 69% (95% CI, 56%-80%) for major BRVO and in 53% (95% CI, 27%-79%) for macular BRVO, with median final VA of 20/60 for both BRVO types. Major and macular BRVOs are 2 distinct clinical entities, and initial visual status and final visual outcome in the 2 types are quite different. Overall, on resolution of macular edema, our study suggests that in both major and macular BRVO, VA and visual fields improved to a variable degree in the majority of eyes without any treatment.

Retinal Vein Occlusion - physiopathology

Visual Fields - physiology

Humans

Middle Aged

Male

Retinal Vein - physiopathology

Hypertension - physiopathology

Young Adult

Diabetes Mellitus - physiopathology

Macular Edema - physiopathology

Aged, 80 and over

Myocardial Ischemia - physiopathology

Adult

Female

Aged

Visual Field Tests

Visual Acuity - physiology

Details

Title: Subtitle: Branch retinal vein occlusion: natural history of visual outcome
Creators: Sohan Singh Hayreh - Department of Ophthalmology and Visual Sciences, College of Medicine, University of Iowa, Iowa City
M Bridget Zimmerman - Department of Biostatistics, College of Public Health, University of Iowa, Iowa City
Resource Type: Journal article
Publication Details: JAMA ophthalmology, Vol.132(1), pp.13-22
DOI: 10.1001/jamaophthalmol.2013.5515
PMID: 24158729
NLM abbreviation: JAMA Ophthalmol
ISSN: 2168-6165
eISSN: 2168-6173
Publisher: United States
Grant note: EY-1151 / NEI NIH HHS
Language: English
Date published: 01/2014
Academic Unit: Biostatistics; Ophthalmology and Visual Sciences
Record Identifier: 9983979972002771

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