Branch Retinal Vein Occlusion Natural History of Visual Outcome
Branch Retinal Vein Occlusion Natural History of Visual Outcome
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DOI：
10.1001/jamaophthalmol.2013.5515
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发表时间：
2014-01-01
影响因子：
8.1
通讯作者：
Zimmerman, M. Bridget
中科院分区：
文献类型：
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作者：
Hayreh, Sohan Singh;Zimmerman, M. Bridget
重要性了解自然历史的视觉结果在分支视网膜静脉阻塞（BRVO）是根本的管理。目的调查自然历史的视觉结果在主要和黄斑BRVO.DESIGN设置和参与者观察性队列研究在大学为基础的转诊实践从1973年至1999年。该研究包括216眼连续BRVO（144眼主要和72眼黄斑BRVO）内看到3个月onset.INTERVENTION首次访问时，所有患者有详细的眼科和病史和全面的眼科评估。眼科评估在初始和后续访问包括记录最佳矫正视力（VA）使用Snellen VA图表和视野与Goldmann perimeter.Main结局和措施最佳矫正视力和视野结局follow-up.Results黄斑水肿解决的中位时间为21个月，主要BRVO和18个月，在那些与黄斑BRVO。总体而言，对于初始VA为20/60或更好的患眼，75%（95% CI，63%-86%）的主要BRVO和86%（95% CI，73%-95%）的黄斑BRVO的VA改善或保持稳定。在初始视力为20/70或更差的患者中，69%的患者视力改善（95% CI，56%-80%），主要BRVO和53%（95%CI，27%-79%），两种BRVO类型的最终VA中位数为20/60。结论和相关性主要和黄斑BRVO是2种不同的临床实体，两种类型的初始视力状态和最终视力结果有很大差异。总的来说，关于黄斑水肿的解决，我们的研究表明，在没有任何治疗的情况下，大多数眼睛的主要和黄斑BRVO、VA和视野都有不同程度的改善。
IMPORTANCE Understanding the natural history of visual outcome in branch retinal vein occlusion (BRVO) is fundamental to its management.OBJECTIVE To investigate the natural history of visual outcome in major and macular BRVO.DESIGN SETTING AND PARTICIPANTS Observational cohort study at a university-based referral practice from 1973 until 1999. The study comprised 216 consecutive eyes with BRVO (144 eyes with major and 72 eyes with macular BRVO) seen within 3 months of onset.INTERVENTION At first visit, all patients had a detailed ophthalmic and medical history and comprehensive ophthalmic evaluation. Ophthalmic evaluation at initial and follow-up visits included recording best-corrected visual acuity (VA) using the Snellen VA chart and visual fields with a Goldmann perimeter.MAIN OUTCOMES AND MEASURES Best-corrected VA and visual field outcome on follow-up.RESULTS The median time to macular edema resolution was 21 months in those with major BRVO and 18 months in those with macular BRVO. Overall, for eyes with initial VA of 20/60 or better, VA improved or remained stable in 75% (95% Cl, 63%-86%) for major BRVO and 86% (95% Cl, 73%-95%) for macular BRVO. In those with initial VA of 20/70 or worse, VA improved in 69% (95% Cl, 56%-80%) for major BRVO and in 53% (95% Cl, 27%-79%) for macular BRVO, with median final VA of 20/60 for both BRVO types.CONCLUSIONS AND RELEVANCE Major and macular BRVOs are 2 distinct clinical entities, and initial visual status and final visual outcome in the 2 types are quite different. Overall, on resolution of macular edema, our study suggests that in both major and macular BRVO, VA and visual fields improved to a variable degree in the majority of eyes without any treatment.