Natural course of perfused central retinal vein occlusion

Objective: To investigate the visual prognosis in perfused (nonischemic) central retinal vein occlusion (CRVO), to determine the frequency of conversion from perfused to nonperfused CRVO, and to identify risk factors for poor visual outcome. Design: Case series. Setting: Retina referral centre in Portland, Ore. Patients: Fifty-eight patients (59 eyes) with perfused CRVO followed for at least 1 year (average 2.5 years). Main outcome measures: Visual acuity, progression to nonperfused CRVO. Results: At the final follow-up visit the visual acuity had improved by two or more lines in 9 eyes (15%), remained the same in 33 eyes (56%) and decreased by two or more lines in 17 eyes (29%). Factors significantly related to visual outcome were initial visual acuity (p = 0.0001) and age, older patients having a worse visual outcome (p = 0.0029). Nine eyes (15%) progressed to nonperfused CHVO. None of the factors analysed, including age, sex, duration of symptoms and initial visual acuity, were predictive of progression. Conclusions: Perfused CRVO frequently results in significant, permanent visual loss, and a poor visual outcome is most likely in older patients and those with poor initial visual acuity