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Laser-induced chorioretinal venous anastomosis most successful in younger patients
Laser-induced chorioretinal venous anastomosis had an increased success rate in the treatment of nonischemic central retinal vein occlusion in patients with younger age, better baseline visual acuity and no hypertension, according to a study.
The Central Retinal Vein Bypass Study, a prospective, randomized, multicenter trial, compared laser-induced chorioretinal venous anastomosis (L-CRA) with conventional treatment for CRVO. Fifty-five patients with nonischemic CRVO received an L-CRA and were further analyzed to determine the systemic and ocular factors that predict the successful creation of an L-CRA and are involved in the development of complications.
Successful L-CRA was achieved in 42 patients (76.4%) at 18 months. There were significant correlations between successful L-CRA creation and younger age (P = .03), better baseline visual acuity (P = .04) and absence of hypertension (P = .001). Evidence of rupture of the vein wall when the L-CRA was attempted was associated with increased success (P = .008).
Sex and duration of CRVO were not associated with a higher chance of success, and location of the laser spot and distance from the optic disc had no appreciable impact on success.
“High baseline central venous pressure, prolonged fluorescein transit time and the presence of any retinal ischemia were associated with a higher incidence of neovascular complications,” the study authors said.