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Central retinal vein occlusion in younger Swedish adults : Case reports and review of the literature

Wittström, Elisabeth LU (2017) In Open Ophthalmology Journal 11. p.89-102
Abstract

Purpose: To investigate associated systemic diseases, other conditions, visual outcome, ocular complications and treatment in Swedish patients younger than 50 years with central retinal vein occlusion (CRVO) and reviewing the literature. Methods: Twenty-two patients with CRVO, younger than 50 years, were examined with full-field electroretinography (ERG) within 3 months after a thrombotic event, or were periodically examined and were observed for at least 6 months. In 18 of these patients, the initial retinal ischemia was studied using the cone b-wave implicit time in the 30 Hz flicker ERG. Fifteen patients also underwent fluorescein angiography. Optical coherence tomography (OCT) was performed in 14 patients. The patients studied were... (More)

Purpose: To investigate associated systemic diseases, other conditions, visual outcome, ocular complications and treatment in Swedish patients younger than 50 years with central retinal vein occlusion (CRVO) and reviewing the literature. Methods: Twenty-two patients with CRVO, younger than 50 years, were examined with full-field electroretinography (ERG) within 3 months after a thrombotic event, or were periodically examined and were observed for at least 6 months. In 18 of these patients, the initial retinal ischemia was studied using the cone b-wave implicit time in the 30 Hz flicker ERG. Fifteen patients also underwent fluorescein angiography. Optical coherence tomography (OCT) was performed in 14 patients. The patients studied were divided into two groups, non-ischemic and ischemic, which were compared. All patients underwent ocular and systemic examination, as well as complete screening for thrombophilic risk factors. Results: Of the 22 patients, 15 had non-ischemic type of CRVO and 7 the ischemic type. Patients with non-ischemic CRVO showed significantly improved visual acuity (VA) at the final examination (p=0.006). Patients with ischemic CRVO showed no significant reduction in VA at the final examination (p=0.225). Systemic hypertension (27% in non-ischemic CRVO and 29% in ischemic CRVO) was the most prevalent systemic risk factor for CRVO. The mean central foveal thickness (CFT) decreased significantly from 402.3±136.2 (μm) at the initial examination to 243.8±48.1 (μm) at the final examination in the non-ischemic group (p=0.005). The mean initial CFT was 444.5±186.1 (μm) in the ischemic CRVO group, which decreased to 211.5±20.2 (μm) at the final visit (p=0.068). Pigment dispersion syndrome (PDS)/pigmentary glaucoma (PG), ocular hypertension and dehydration were equally frequent; four patients each (18%) out of 22. The clinical course of 4 younger patients with PDS/PG are described. Conclusion: The patients with non-ischemic CRVO showed significantly improved VA and significantly decreased CFT at the final examination. Systemic hypertension was the most prevalent risk factor for CRVO. Younger adults with CRVO also had a high prevalence of PDS/PG, ocular hypertension and dehydration. This study highlights the importance of careful IOP monitoring, and the need to investigate possible PDS/PG and to obtain an accurate history of the patient including alcohol intake and intense exercise.

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organization
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type
Contribution to journal
publication status
published
subject
keywords
Central retinal vein occlusion, Dehydration, Pigment dispersion syndrome/pigmentary glaucoma, Younger Swedish adults
in
Open Ophthalmology Journal
volume
11
pages
14 pages
publisher
Bentham Science Publishers
external identifiers
  • scopus:85025839144
ISSN
1874-3641
DOI
10.2174/1874364101711010089
language
English
LU publication?
yes
id
04439e80-927f-49f5-83a8-f066a7436064
date added to LUP
2017-08-30 11:09:38
date last changed
2017-08-31 03:00:02
@article{04439e80-927f-49f5-83a8-f066a7436064,
  abstract     = {<p>Purpose: To investigate associated systemic diseases, other conditions, visual outcome, ocular complications and treatment in Swedish patients younger than 50 years with central retinal vein occlusion (CRVO) and reviewing the literature. Methods: Twenty-two patients with CRVO, younger than 50 years, were examined with full-field electroretinography (ERG) within 3 months after a thrombotic event, or were periodically examined and were observed for at least 6 months. In 18 of these patients, the initial retinal ischemia was studied using the cone b-wave implicit time in the 30 Hz flicker ERG. Fifteen patients also underwent fluorescein angiography. Optical coherence tomography (OCT) was performed in 14 patients. The patients studied were divided into two groups, non-ischemic and ischemic, which were compared. All patients underwent ocular and systemic examination, as well as complete screening for thrombophilic risk factors. Results: Of the 22 patients, 15 had non-ischemic type of CRVO and 7 the ischemic type. Patients with non-ischemic CRVO showed significantly improved visual acuity (VA) at the final examination (p=0.006). Patients with ischemic CRVO showed no significant reduction in VA at the final examination (p=0.225). Systemic hypertension (27% in non-ischemic CRVO and 29% in ischemic CRVO) was the most prevalent systemic risk factor for CRVO. The mean central foveal thickness (CFT) decreased significantly from 402.3±136.2 (μm) at the initial examination to 243.8±48.1 (μm) at the final examination in the non-ischemic group (p=0.005). The mean initial CFT was 444.5±186.1 (μm) in the ischemic CRVO group, which decreased to 211.5±20.2 (μm) at the final visit (p=0.068). Pigment dispersion syndrome (PDS)/pigmentary glaucoma (PG), ocular hypertension and dehydration were equally frequent; four patients each (18%) out of 22. The clinical course of 4 younger patients with PDS/PG are described. Conclusion: The patients with non-ischemic CRVO showed significantly improved VA and significantly decreased CFT at the final examination. Systemic hypertension was the most prevalent risk factor for CRVO. Younger adults with CRVO also had a high prevalence of PDS/PG, ocular hypertension and dehydration. This study highlights the importance of careful IOP monitoring, and the need to investigate possible PDS/PG and to obtain an accurate history of the patient including alcohol intake and intense exercise.</p>},
  author       = {Wittström, Elisabeth},
  issn         = {1874-3641},
  keyword      = {Central retinal vein occlusion,Dehydration,Pigment dispersion syndrome/pigmentary glaucoma,Younger Swedish adults},
  language     = {eng},
  month        = {05},
  pages        = {89--102},
  publisher    = {Bentham Science Publishers},
  series       = {Open Ophthalmology Journal},
  title        = {Central retinal vein occlusion in younger Swedish adults : Case reports and review of the literature},
  url          = {http://dx.doi.org/10.2174/1874364101711010089},
  volume       = {11},
  year         = {2017},
}