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Title: Natural History of Central Retinal Vein Occlusion: An Evidence-Based Systematic Review
Authors: McIntosh, R.L.
Rogers, S.L.
Lim, L.
Cheung, N.
Wang, J.J.
Wong, T.Y. 
Mitchell, P.
Kowalski, J.W.
Nguyen, H.P.
Issue Date: 2010
Citation: McIntosh, R.L.,Rogers, S.L.,Lim, L.,Cheung, N.,Wang, J.J.,Wong, T.Y.,Mitchell, P.,Kowalski, J.W.,Nguyen, H.P. (2010). Natural History of Central Retinal Vein Occlusion: An Evidence-Based Systematic Review. Ophthalmology 117 (6). ScholarBank@NUS Repository.
Abstract: Objective: To describe the natural history of central retinal vein occlusion (CRVO) based on the best available evidence from the literature. Clinical Relevance: Central retinal vein occlusion is a common sight-threatening retinal vascular disease. Despite the introduction of new interventions, the natural history of CRVO is unclear. Methods: Systemic review of all English language articles retrieved using a keyword search of MEDLINE, EMBASE, Current Contents, and the Cochrane Library to November 13, 2008. This was supplemented by hand-searching references of review articles published within the last 5 years. Two investigators independently identified all relevant observational studies evaluating the natural history of RVO and all clinical trials evaluating interventions for CRVO; an untreated control arm was included. Results: Of 5966 citations retrieved, 53 studies were reviewed, providing 3271 eyes with CRVO for analysis of its natural history. Visual acuity (VA) was generally poor at baseline (<20/40) and decreased further over time. Although 6 studies reported an improvement in VA, none of these improvements resulted in VA better than 20/40. Up to 34% of eyes with nonischemic CRVO converted to ischemic CRVO over a 3-year period. In ischemic CRVO cases, neovascular glaucoma developed in at least 23% of eyes within 15 months. In nonischemic CRVO cases, macular edema resolved in approximately 30% of eyes over time, and subsequent neovascular glaucoma was rare. Conclusions: Untreated eyes with CRVO generally had poor VA, which declined further over time. One quarter of eyes with nonischemic CRVO converted to ischemic CRVO. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. © 2010 American Academy of Ophthalmology.
Source Title: Ophthalmology
ISSN: 01616420
DOI: 10.1016/j.ophtha.2010.01.060
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