Artikel
Iris neovasculasrization as a complication of central retinal artery occlusion
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Autoren
Veröffentlicht: | 22. September 2004 |
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Gliederung
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Objective
The incidence of iris neovascularization (IN) with secondary angle closure glaucoma as complication of the central retinal artery occlusion (CRAO) is greatly underestimated.
Methods
In a retrospective study we analysed all patients with CRAO seen within the last 2 years, who were treated at our department. We looked especially for the frequency of the occurrence of IN.
Results
In 27 patients with CRAO 5 developed an IN with a secondary neovascular glaucoma with high intraocular pressure (30 to 48 mmHg, 3 cases with painful eye). Thus the frequency of IN was 18 % in our patients. The IN occurred 2 months to 2 years after the occlusion (in 3 patients within the first 3 months, in one patient after 6 months and in 1 patient after 2 years). Visual acuity in three eyes was between 1/20 to light perception and two eyes had no light perception. In all cases a panretinal laser treatment was performed. 3 eyes were additionally treated with a peripheral retinal cryocoagulation and cyclophotocoagulation which resulted in a drop of intraocular pressure under 24 mmHg. In the history of these patients, diabetes mellitus and arterial hypertension was found. Two patients had cerebral vascular insults prior to the CRAO.
Conclusions
In previous studies it has been shown, that ischemia/reperfusion injuries of the retina after CRAO predispose to IN (incidence 3-18 %). Although it has been shown, that the majority of IN occurs within three months, our data show that IN may occur as a severe complication of CRAO even later. Patients should be followed monthly in the first 6 months (including gonioscopy), thereafter follow-up should be conducted every 3 months to diagnose the occurrence of IN early. Treatment should be panretinal laser coagulation or in case of a secondary close angle glaucoma cyclophotocoagulation therapy respectivly.