To evaluate panretinal photocoagulation for ischemic central vein occlusion and macular grid-pattern photocoagulation for macular edema with reduced visual acuity due to central vein occlusion and to further define the natural history of central vein occlusion.
A multicenter randomized controlled clinical trial supported by the National Eye Institute, Bethesda, Md.
A total of 728 eyes from 725 patients were entered into one or more of four study groups: perfused, nonperfused, indeterminate perfusion, and macular edema.
Follow-up of study patients is still in progress and no results are available for the randomized groups (nonperfused and macular edema). Thirtyeight (83%) of 46 evaluable eyes in the indeterminate group eventually demonstrated at least 10 disc areas of nonperfusion (28 eyes) or developed iris and/or angle neovascularization before retinal status could be determined (10 eyes). Four-month follow-up information is available for 522 of the 547 eyes in the perfused group. Thirty of these 522 eyes demonstrated iris and/or angle neovascularization at or before the 4-month follow-up visit. An additional 51 eyes had developed evidence of at least 10 disc areas of nonperfusion by the time of the 4-month visit.
These findings confirm the importance of frequent follow-up examinations, including undilated slitlamp examination of the iris, and gonioscopy in the management of all patients with recent onset of central vein occlusion.
Baseline and Early Natural History ReportThe Central Vein Occlusion Study. Arch Ophthalmol. 1993;111(8):1087-1095. doi:10.1001/archopht.1993.01090080083022