[Iris neovascularization as a complication of central artery occlusion].
BACKGROUND
Iris neovascularization (IN) with a secondary angle closure glaucoma is a complication of central retinal artery occlusion (CRAO). Its incidence is greatly underestimated.


METHODS
In a retrospective study we analyzed all patients with CRAO seen within 2 years who were treated in our department. We looked especially for the frequency of the occurrence of IN.


RESULTS
In 27 patients with CRAO, 5 developed an IN with a secondary neovascular glaucoma with high intraocular pressure. Thus, the frequency of IN was 18 % in our patients. The IN occurred 2 months to 2 years after the occlusion. Visual acuity in three eyes was between 1/20 and light perception and two eyes had no light perception. In all cases a panretinal laser treatment was performed. Three eyes were additionally treated with a peripheral retinal cryocoagulation and cyclophotocoagulation. In the histories of these patients, diabetes mellitus and arterial hypertension were found.


CONCLUSIONS
In previous studies it has been shown, that ischemia/reperfusion injuries of the retina after CRAO predispose to IN (incidence 3 - 18 %). Although it has been shown that the majority of IN occurs within three months, our data show that IN may occur as a severe complication of CRAO even later. Patients should be followed-up closely (including gonioscopy), to diagnose the occurrence of IN early. Recommended treatment is panretinal laser coagulation or -- in the case of a secondary angle closure glaucoma -- cyclophotocoagulation, respectively.
Schäfer
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Universitätsklinikum, Augenklinik Ulm. sabine.schaefer@medizin.uni-ulm.de
Lang
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GE
D015897:Comorbidity; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D015812:Glaucoma, Angle-Closure / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D015355:Glaucoma, Neovascular / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007498:Iris / Q000098:blood supply*; D009389:Neovascularization, Pathologic / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D015356:Retinal Artery Occlusion / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies; D013223:Statistics as Topic; D015354:Vision, Low / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology