Hemicentral retinal vein occlusion: natural history of visual outcome

To investigate the natural history of visual outcome in hemicentral retinal vein occlusion (HCRVO).

The study comprised 65 consecutive HCRVO patients (67 eyes) seen within 3 months of onset. 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 visual acuity using the Snellen visual acuity chart, and visual fields with a Goldmann perimeter. Hemicentral retinal vein occlusion was classified into nonischemic (57 eyes) and ischemic (10 eyes) at initial visit.

Nonischemic HCRVO involved superior and inferior half of the retina in 39% and 56%, respectively, and in ischemic HCRVO in 50% and 40%, respectively. In nonischemic HCRVO, initial visual acuity was 20/60 or better in 73.7% and minimal to mild visual field loss in 96% and in ischemic HCRVO in 40% and 55.5%, respectively. After resolution of macular edema, in nonischemic HCRVO eyes, cumulative chance of improvement was 50% with 20/70 or worse initial visual acuity, and deterioration in only 6% with 20/60 or better initial visual acuity, and in 5% with minimal to mild visual initial field loss.

This study suggests a good prognosis in the natural history of visual outcome in nonischemic HCRVO.