The venous closing pressure in central retinal vein obstruction.
OBJECTIVE
To assess the rate of change in the central retinal venous closing pressure in central retinal vein obstruction over time, and its relationship to visual acuity improvement and the development of rubeosis iridis.


METHODS
Fifty patients presenting with central retinal vein obstruction of less than three months' duration, between the ages of 40 and 80 years, were reviewed prospectively. The central retinal venous closing pressure was measured by digital ocular compression. Patients were discharged from the study after the six-month visit.


RESULTS
All patients had elevated venous closing pressure at presentation, whereas at six months only 24 patients had persistent elevation. Of 16 patients with lowering of the venous closing pressure within four months of onset of central retinal vein obstruction, 11 (69%) had two or more lines of visual acuity improvement. Only two of 10 patients (20%) developing lowering of the venous closing pressure thereafter had visual improvement. No patient developed rubeosis iridis after the venous closing pressure lowered.


CONCLUSIONS
The central retinal venous closing pressure is raised in central retinal vein obstruction to about central retinal arterial diastolic pressure, and is its pathognomonic sign. This sign is easily elicited via digital pressure on the eyelid, and has prognostic significance for visual acuity improvement and the development of rubeosis iridis.
Moorfields Eye Hospital, London.
A P
AP
Luckie
J J
JJ
Wroblewski
A C
AC
Bird
A M
AM
Hamilton
M D
MD
Sanders
W
W
Green
N G
NG
Slater
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005654:Fundus Oculi; D006438:Hemodilution; D006801:Humans; D007429:Intraocular Pressure; D007498:Iris / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012169:Retinal Vein / Q000503:physiopathology*; D012170:Retinal Vein Occlusion / Q000503:physiopathology* / Q000628:therapy; D014690:Venous Pressure; D014792:Visual Acuity