Population-Based Incidence of Ocular Neovascularization Following Central Retinal Artery Occlusion in Olmsted County, Minnesota

Tanke, Laurel B.; Chodnicki, Kevin; Olsen, Timothy W.; Bhatti, M. Tariq; Chen, John J.

doi:10.2147/opth.s327704

Cited by 4 publications

(8 citation statements)

References 14 publications

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“…To our knowledge, this represents the largest series of visual outcome data showing the clinical impact of post-CRAO ONV. Jung et al 10 found a 41.7% incidence of final NLP status among 12 patients with post-CRAO ONV, while Tanke et al 7 described a corresponding incidence of 21.4%. However, the timing of total blindness in both studies was not reported.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6] This is driven by proangiogenic factor expression in the setting of acute retinal hypoxia. 6,7 Presentations of ONV include neovascular disc, neovascularization elsewhere, and neovascular iris (NVI). 7 Neovascularization of the iridocorneal angle is the preceding event for neovascular glaucoma (NVG), which represents an ophthalmic emergency.…”

Section: Introductionmentioning

confidence: 99%

“…7 Neovascularization of the iridocorneal angle is the preceding event for neovascular glaucoma (NVG), which represents an ophthalmic emergency. 7,8 The timing of ONV onset has been reported 1 to 3 months after the initial CRAO. 6,7,[9][10][11] Previous retrospective studies have also identified diabetes mellitus (DM) type 2, chronic kidney disease (CKD), and glaucoma as risk factors for post-CRAO ONV.…”

Section: Introductionmentioning

confidence: 99%

“…7,8 The timing of ONV onset has been reported 1 to 3 months after the initial CRAO. 6,7,[9][10][11] Previous retrospective studies have also identified diabetes mellitus (DM) type 2, chronic kidney disease (CKD), and glaucoma as risk factors for post-CRAO ONV. 9,11 However, to our knowledge no data describing the visual impact of this secondary complication have been published.…”

Section: Introductionmentioning

confidence: 99%

“…6,7 Presentations of ONV include neovascular disc, neovascularization elsewhere, and neovascular iris (NVI). 7 Neovascularization of the iridocorneal angle is the preceding event for neovascular glaucoma (NVG), which represents an ophthalmic emergency. 7,8 The timing of ONV onset has been reported 1 to 3 months after the initial CRAO.…”

Section: Introductionmentioning

confidence: 99%

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Incidence of Total Blindness After Central Retinal Artery Occlusion With Ocular Neovascularization

Chawla,

Redrick,

Pannell

et al. 2023

Journal of VitreoRetinal Diseases

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Purpose: To determine the time-based incidence of total blindness after central retinal artery occlusion (CRAO) with secondary ocular neovascularization (ONV). Methods: In this retrospective cohort study, electronic records were queried using ICD-9 and ICD-10 codes to identify patients with secondary ONV post-CRAO. Patients with possible alternative ONV etiologies, previous panretinal photocoagulation (PRP), and/or previous antivascular endothelial growth factor (VEGF) therapy were excluded. Clinical data included demographics, medical comorbidities, ONV manifestations, medical/surgical management, and best-corrected visual acuity (BCVA). Kaplan-Meier analysis was performed with total blindness (defined as a BCVA of no light perception) as the outcome of interest. Results: Of 345 eyes with CRAO, 34 met the inclusion criteria with a mean (±SD) follow-up of 22.0 ± 26.2 months. ONV management included PRP (70.6%), glaucoma drainage implant surgery or transscleral cyclophotocoagulation (32.4%), and intravitreal anti-VEGF therapy (mean 2.8 ± 5.6 injections per patient). The cumulative incidence of total blindness was 49.4% (95% confidence interval, 27.2%-71.6%) at 24 months, with 53.3% of cases occurring within 4 months of ONV onset. Conclusions: Post-CRAO ONV is associated with a high risk for progression from severe vision loss to total blindness. Neovascular glaucoma can present up to 4 months after CRAO, challenging the paradigm of “30-day-glaucoma.” Routine gonioscopy should extend through this period, while glaucoma surgery can delay further vision loss. These findings can be used to counsel patients on the importance of follow-up adherence.

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Section: Discussionmentioning

confidence: 99%