Argon laser panretinal photocoagulation in ischemic central retinal vein occlusion. A 10-year prospective study.
We conducted a prospective, planned study of argon laser panretinal photocoagulation (PRP) in ischemic central retinal vein occlusion (CRVO) over a 10-year period in 123 eyes. On comparing the lasered eyes versus the nonlasered eyes, there was no statistically significant difference between the two groups in the incidence of development of angle neovascularization (NV), neovascular glaucoma (NVG), retinal and/or optic disc NV, or vitreous hemorrhage, or in visual acuity. Our study, however, did show a statistically significant (P = 0.04) difference in the incidence of iris NV between the two groups, with iris NV less prevalent in the laser group than in the nonlaser group, but only when the PRP was performed within 90 days after the onset of CRVO. The other parameter which showed a statistically significant difference between the two groups was the peripheral visual fields-the laser group suffered a significantly (P less than or equal to 0.03) greater loss than the non-laser group. We discuss the implications of these findings in light of the natural history of ischemic CRVO and of ocular NV. Since the original rationale for advocating PRP in ischemic CRVO was the proven beneficial effect of PRP on ocular NV in proliferative diabetic retinopathy, we also discuss the disparities in the disease process between ischemic CRVO and proliferative diabetic retinopathy and in their responses to PRP.
Hayreh
S S
SS
Department of Ophthalmology, University of Iowa, Iowa City.
Klugman
M R
MR
Podhajsky
P
P
Servais
G E
GE
Perkins
E S
ES
D000368:Aged; D000704:Analysis of Variance; D002985:Clinical Protocols; D003627:Data Interpretation, Statistical; D005260:Female; D015355:Glaucoma, Neovascular / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D007498:Iris / Q000098:blood supply; D007511:Ischemia / Q000601:surgery*; D008028:Light Coagulation / Q000009:adverse effects; D008297:Male; D009389:Neovascularization, Pathologic; D009898:Optic Disk / Q000098:blood supply; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D015861:Retinal Neovascularization / Q000453:epidemiology / Q000209:etiology; D012170:Retinal Vein Occlusion / Q000601:surgery*; D014794:Visual Fields; D014823:Vitreous Hemorrhage / Q000453:epidemiology / Q000209:etiology