To describe the natural history of central retinal vein occlusion (CRVO) based on
the best available evidence from the literature.
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.
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.
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.
Untreated eyes with CRVO generally had poor VA, which declined further over time.
One quarter of eyes with nonischemic CRVO converted to ischemic CRVO.
Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights
reserved.