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   Table of Contents      
LETTER TO EDITOR
Year : 1997  |  Volume : 45  |  Issue : 4  |  Page : 261-262

Central retinal vein occlusion study


Correspondence Address:
K S Sangha


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Source of Support: None, Conflict of Interest: None


PMID: 9567028

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How to cite this article:
Sangha K S. Central retinal vein occlusion study. Indian J Ophthalmol 1997;45:261-2

How to cite this URL:
Sangha K S. Central retinal vein occlusion study. Indian J Ophthalmol [serial online] 1997 [cited 2020 Aug 9];45:261-2. Available from: http://www.ijo.in/text.asp?1997/45/4/261/14986

Editor

This communication concerns the article by Saxena.[1] In this article the author does not make a reference to the visual acuity (VA) in central retinal vein occlusion. The central vein occlusion study[2] and even some older studies[3] have made wonderful recommendations based upon the initial VA of patients. According to them, there is a strong corelation of the VA with the perfused versus non-perfused status of CRVO. Some studies[3] rank VA (followed by kinetic perimetry, relative afferent pupillary defect, and ERG, in that order) as a better prognostic indicator than fluorescein angiography. It has been suggested that poor initial VA and a drop in VA during the natural history of the disease are a pointer towards non-perfused status and the conversion from perfused to non-perfused state, respectively.

This in effect means that once diagnosed as CRVO, all cases need not be referred to a retina specialist. As per CVOS guidelines[2] these patients can be divided, prognostically, into three groups.



  1. a. Those with VA <6/60 have a poor visual prognosis (80% remain at that level or worse). Such a patient is likely to have a non-perfused retina.


  2. b. Those having VA between 6/60 and 6/15 have variable visual prognosis. These patients may be informed that their VA may improve (1 in 5 chance approximately), may stay at the same level (nearly half do so), or may get worse.


  3. c. If initial VA is ≥6/12, there is a good likelihood of retaining good vision and the retina is likely to be perfused.




It follows logically that patients in the last group do not need a retinal evaluation from a retina specialist. Those in the second group may need a retinal evaluation, and those in the first group should definitely be referred to a retina specialist. Another important fact to remember is that any drop in VA in any group is a bad omen, and should be taken seriously, both by the general ophthalmologist and the treating retina specialist.



 
  References Top

1.
Saxena S. Laser photocoagulation in retinal vein occlusion: Branch Vein Occlusion Study and Central Vein Occlusion Study recommendations. Indian J Ophthalmol 1997;45:125-28.  Back to cited text no. 1
    
2.
The Central Vein Occlusion Study Group. Natural history and clinical management of CRVO. Arch Ophthalmol 1997;115:486-91.  Back to cited text no. 2
    
3.
Hayreh SS, Klugman MR, Beri M, Kimura AE, Podhajsky P. Differentiation of ischaemic from non-ischaemic CRVO during the early acute phase. Graefes Arch Clin Exp Oph 1990;228:201-17.  Back to cited text no. 3
    




 

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