Korean J Ophthalmol.  2010 Apr;24(2):83-88. 10.3341/kjo.2010.24.2.83.

Clinical Progress in Impending Central Retinal Vein Occlusion

• Lee DH
• Lee SJ
• Yoon IN

• KMID: 945999
• DOI: http://doi.org/10.3341/kjo.2010.24.2.83

Abstract

PURPOSE
Impending central retinal vein occlusion is associated with mild or no loss of vision; however, its progress and vision prognosis have not been clearly defined until now. Therefore, we studied the progress and prognoses in patients with impending central retinal vein occlusion. METHODS: For this study, we selected ten subjects who had been diagnosed with impending central retinal vein occlusion, and we retrospectively reviewed their progress and prognoses. RESULTS: The average age of the subjects was 31.0 years (18 to 48 years). Eight patients were male and two were female. The average observational period was 5.5 months. Six out of ten subjects were found to have no underlying systemic disease, four subjects had underlying disease. All ten patients were affected unilaterally. When initially tested, the affected eyes showed an average vision of LogMar 0.30. The final vision test revealed an average of LogMar 0.04, which indicates good progress and prognosis. In one patient, retinal hemorrhage and macular edema progressively worsened after the diagnosis, and the patient was treated with radial optic neurotomy. CONCLUSIONS: The cases of impending central retinal vein occlusion that we observed seemed to primarily affect young patients with generally good prognoses. However, in some cases, the degrees of obstruction and hemorrhage increased as time progressed. This suggests that impending central retinal vein occlusion could develop into the prodromal phase of an acute attack.

Keyword

Prognosis; Retinal vein occlusion; Young adult

MeSH Terms

Adolescent
Adult
Disease Progression
Female
Humans
Male
Middle Aged
Prognosis
Retinal Vein Occlusion/*physiopathology
Retrospective Studies

Figure

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  Fig. 1 Case 3. (A) Fundus findings of slightly tortuous and engorged retinal veins at first visit. (B) After one month, the retinal venous tortuosity and engorgement were no longer present.

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  Fig. 2 Case 6. (A) Fundus findings of flame-shaped retinal hemorrhage, moderated retinal venous engorgement, cotton-wool spots and dot hemorrhage at first visit. (B) After two months, the fundus returned to its normal appearance.

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  Fig. 3 Case 8. (A) Fundus findings of some dot retinal hemorrhages and moderated retinal venous engorgement at first visit. (B) After two weeks, the flame-shaped retinal hemorrhages and vascular tortuosity increased. Vitrectomy, radical optic neurotomy and intravitreal triamcinolone injection were performed. (C) Two weeks after radial optic neurotomy, retinal hemorrhage and tortuosity decreased. (D) After six months, the fundus returned to its normal appearance.

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  Fig. 4 Case 9. (A) Fundus findings of retinal dot hemorrhages, enlarged retinal vein and mild disc swelling at first visit. (B) After two weeks, the disc swelling and macular edema worsened and a hard exudation appeared at the posterior pole.

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