Electrophysiological evaluation and visual outcome in patients with central retinal vein occlusion, primary open‐angle glaucoma and neovascular glaucoma

Wittström, Elisabeth; Ponjavic, Vesna; Lövestam-Adrian, Monica; Larsson, Jörgen; Andréasson, Sten

doi:10.1111/j.1755-3768.2008.01424.x

Cited by 12 publications

(13 citation statements)

References 33 publications

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“…This accumulation of the pigment granules may cause obstruction and damage to the trabecular meshwork, which will be followed by a decrease in aqueous outflow, and elevated IOP and PG [58-61]. The association between CRVO and ocular hypertension, as well as various types of glaucoma, is well-known in older patients [29-32, 38, 39]. However, the association between CRVO and glaucoma, especially PDS/PG, is not well recognized in younger patients with CRVO.…”

Section: Discussionmentioning

confidence: 99%

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Central Retinal Vein Occlusion in Younger Swedish Adults: Case Reports and Review of the Literature

Wittström

2017

TOOPHTJ

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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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Section: Discussionmentioning

confidence: 99%

“…The prevalence of glaucoma in patients with CRVO has been reported to range from 6% to 69% [29-32]. Elevated intraocular pressure (IOP) and a large cup-to-disc ratio have been found to be associated with the development of CRVO in patients with glaucoma and ocular hypertension [3, 33-36].…”

Section: Introductionmentioning

confidence: 99%

Central Retinal Vein Occlusion in Younger Swedish Adults: Case Reports and Review of the Literature

Wittström

2017

TOOPHTJ

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“…2003), and highly abnormal ERG predicts a poorer prognosis (Larsson et al. 1998; Wittstrom et al. 2010).…”

Section: Discussionmentioning

confidence: 99%

“…Subclinical retinal dysfunction can be detected by mfERG before retinopathy develops (Palmowski et al 1997;Fortune et al 1999;Han et al 2004b). In central retinal vein occlusion, a selective disease of the retinal circulation reduced P1 amplitudes and delayed P1 implicit times have been found (Dolan et al 2003) together with subclinical P1-abnormalities in fellow eyes that have tentatively been contributed to systemic conditions such as arterial hypertension, diabetes and hypercholestorolaemia (Sakaue et al 1989;Dolan et al 2003), and highly abnormal ERG predicts a poorer prognosis (Larsson et al 1998;Wittstrom et al 2010).…”

Section: Discussionmentioning

confidence: 99%

Cone pathway function in relation to asymmetric carotid artery stenosis: correlation to blood pressure

Kofoed

Munch

Holfort

et al. 2012

Acta Ophthalmologica

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ABSTRACT.Purpose: To examine retinal function in relation to retinal perfusion pressure in patients with carotid artery stenosis. Methods: Thirteen patients with carotid artery stenosis without clinical eye disease underwent assessment of ophthalmic artery systolic blood pressure (OSP) by ocular pneumoplethysmography, carotid artery obstructive disease by ultrasonography, intraocular pressure by applanation tonometry, retinal perfusion by fluorescein angiography and retinal function by multifocal electroretinography (mfERG). Data analysis compared the eye on the most stenotic side with the fellow eye in the same patient. Results: Ophthalmic systolic pressure was 95.8 ± 13.1 mmHg on the side with the highest degree of carotid artery stenosis (mean 94.0%) and 111.7 ± 10.3 mmHg in the fellow eyes on the side with the lesser degree of stenosis (mean 33.9%). Summed mfERG implicit times (N1 and P1) were 3.4% and 2.0% longer (p = 0.013 and 0.021), and N1 and P1 amplitudes were 18.0% and 16.0% (p = 0.0041 and 0.020) lower in eyes on the side with the higher stenosis compared with the contralateral eyes. Shorter implicit times and higher amplitudes were correlated with higher brachial systolic arterial blood pressure (p = 0.0028, 0.011, 0.041 for N1, P1, N2 implicit times, respectively, and p = 0.0086, 0.016, 0.040 for N1, P1, N2 for amplitudes, respectively, corrected for OSP). Conclusion: Cone function deviation was observed in clinically healthy eyes on the side with highest degree of carotid artery stenosis and was found correlated to arterial blood pressure.

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“…The association between POAG and CRVO has been reported in previous studies [2,5,[9][10][11][12] . Elevated IOP can be one of the risk factors for CRVO [24] , and lowering IOP helps to improve the retinal circulation due to increasing the ocular perfusion pressure in eyes with CRVO [6] .…”

Section: Discussionmentioning

confidence: 85%

Clinical Features of Japanese Patients with Central Retinal Vein Occlusion Complicated by Normal-Tension Glaucoma: A Retrospective Study

Fukumoto¹,

Sato²,

Oku³

et al. 2017

Ophthalmologica

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Purpose: The association of central retinal vein occlusion (CRVO) with primary open-angle glaucoma (POAG) or ocular hypertension has been reported, and lowering intraocular pressure (IOP) helps to improve the retinal circulation in eyes with CRVO. However, the clinical features of CRVOs with normal-tension glaucoma (NTG) are not well known. Therefore, we investigated Japanese CRVO patients with NTG. Methods: We retrospectively investigated 234 CRVO patients over 5 years, with follow-ups of more than 12 months, and evaluated the prevalence of glaucoma. Results: Of the 234 CRVO patients, 18 (7.7%) were diagnosed with NTGs (n = 10) or POAGs (n = 8). Seven POAG (87.5%) and 3 NTG (30%) patients had systemic hypertension. At the initial CRVO evaluation, 6 NTGs showed a significantly increased IOP; mean IOP was 13.3 mm Hg before CRVO, 16.2 mm Hg at CRVO, and 13.5 mm Hg at the final visit. Conclusions: The proportion of NTGs with systemic hypertension was low. IOP of NTG patients was significantly elevated at the initial CRVO evaluation, even in the presence of anti-glaucoma drugs.

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Electrophysiological evaluation and visual outcome in patients with central retinal vein occlusion, primary open‐angle glaucoma and neovascular glaucoma

Cited by 12 publications

References 33 publications

Central Retinal Vein Occlusion in Younger Swedish Adults: Case Reports and Review of the Literature

Central Retinal Vein Occlusion in Younger Swedish Adults: Case Reports and Review of the Literature

Cone pathway function in relation to asymmetric carotid artery stenosis: correlation to blood pressure

Clinical Features of Japanese Patients with Central Retinal Vein Occlusion Complicated by Normal-Tension Glaucoma: A Retrospective Study

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