Clinical Characteristics and Treatment Outcomes of Recurrent Central Retinal Vein Occlusions.
OBJECTIVE
To report the ocular findings, systemic hematologic parameters, and treatment outcomes of patients with recurrent central retinal vein occlusions (CRVO).


METHODS
A retrospective analysis of eyes that developed recurrent CRVO was performed. Key exclusion criteria were follow-up of less than six months after the recurrence, incomplete documentation, and recurrent macular edema in an eye with a CRVO but without evidence of increased superficial hemorrhage or disc edema (recurrent CRVO). Collected data included demographic information, history of presenting illness including the previous CRVO, ocular and systemic co-morbidities, and clinical examination findings that included visual acuities and imaging details from the time of initial CRVO diagnosis until the final examination.


RESULTS
Thirteen eyes of 12 subjects with recurrent CRVO were evaluated. The mean age of the patients was 63 years (range: 42 to 79 years). The mean interval between treatment of the initial CRVO and the onset of the recurrent CRVO was 9.0 ± 9.3 months. The visual acuity declined by approximately eight lines at the time of recurrence. Treatment with vascular endothelial growth factor inhibitors and corticosteroids significantly improved mean central macular thickness (CMT) from the time of recurrence until the final examination (808 ± 169 vs. 511 ± 302 µm; P = 0.004), but failed to change visual acuity (1.28 ± 0.31 logMAR vs. 1.24 ± 0.43 logMAR; P = 0.8). No uncontrolled systemic risk factors were associated with recurrences.


CONCLUSIONS
Recurrent CRVO in the same eye occurs infrequently and may not be associated with an uncontrolled systemic disease. Despite multimodal therapy, most eyes do not recover vision to the pre-recurrence level.
a Srimati Kanuri Santhamma Centre for Vitreo-Retinal Diseases, Hyderabad Eye Research Foundation, L. V. Prasad Eye Institute , Hyderabad , India.
Jay
J
Chhablani
b Department of Ophthalmology , Mayo Clinic , Minnesota, FL , USA.
Michael
M
Stewart
a Srimati Kanuri Santhamma Centre for Vitreo-Retinal Diseases, Hyderabad Eye Research Foundation, L. V. Prasad Eye Institute , Hyderabad , India.
Remya
R
Paulose
c Unit of Macula, Department of Ophthalmology , University and Polytechnic Hospital La Fe , Valencia , Spain.
Roberto
R
Gallego-Pinazo
c Unit of Macula, Department of Ophthalmology , University and Polytechnic Hospital La Fe , Valencia , Spain.
Rosa
R
Dolz-Marco
D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000068258:Bevacizumab / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D058449:Intravitreal Injections; D008266:Macula Lutea / Q000473:pathology; D008269:Macular Edema / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D040262:Receptors, Vascular Endothelial Growth Factor / Q000037:antagonists & inhibitors; D012008:Recurrence; D012170:Retinal Vein Occlusion / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity
D020533:Angiogenesis Inhibitors; D005938:Glucocorticoids; D000068258:Bevacizumab; D040262:Receptors, Vascular Endothelial Growth Factor; D014222:Triamcinolone Acetonide
Anti-VEGF; CRVO; macular edema; recurrent CRVO; venous occlusion