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A Comparison of Risk Factors and Clinical Outcomes

Rothman, Adam L., MD*; Thomas, Akshay S., MD, MS*; Khan, Kirin, BS; Fekrat, Sharon, MD*

doi: 10.1097/IAE.0000000000002278
Original Study: PDF Only

Purpose: To compare the presentation and outcomes of patients younger than 50 years versus patients aged 50 years and older with central retinal vein occlusion (CRVO).

Methods: This single-center retrospective study included patients with CRVO presenting between January 2009 and July 2016. Charts were reviewed and data were abstracted. Presenting and final clinical parameters, treatment burden, and predisposing factors for CRVO were compared between the two groups.

Results: Thirty-six patients younger than 50 years and 233 patients aged 50 years and older at the time of CRVO onset were included. At presentation, younger patients had better visual acuity than older patients (20/80 vs. 20/224, P = 0.001) and a lower incidence of cystoid macular edema (54 vs. 79%, P = 0.001). Twenty-one of 36 (58%) younger patients had at least one identifiable nontraditional risk factor for CRVO. At final follow-up, younger patients received fewer total intravitreal injections (3.8 ± 5.8 at 34.2 months) compared with older patients (6.5 ± 8.8, at 37.6 months, P = 0.03) and had better final acuity (20/85 vs. 20/289, P = 0.004, respectively).

Conclusion: Younger patients had better baseline and final acuities, a lower incidence of cystoid macular edema at presentation, and received fewer intravitreal injections than older patients. Workup for etiology of CRVO in younger patients may reveal nontraditional risk factors for CRVO.

Patients younger than 50 years with central retinal vein occlusion may have better presenting and final visual acuities, lower incidence of associated cystoid macular edema, and require fewer intravitreal injections than those aged 50 years and older.

*Department of Ophthalmology, Duke University, Durham, North Carolina; and

Duke University School of Medicine, Durham, North Carolina.

Reprint requests: Sharon Fekrat, MD, Department of Ophthalmology, Duke University, 2351 Erwin Road, Box 3802, Durham, NC 27710; e-mail:

Unrestricted Institutional Grant from Research to Prevent Blindness, New York, NY.

S. Fekrat receives patent royalties from Alcon and is a consultant to Regeneron. The remaining authors have no conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.