Gonioscopic findings in patients with acute central/hemicentral retinal vein occlusions

To evaluate prospectively the gonioscopic findings and their changes during a 3-year follow-up period in patients with acute central/hemicentral retinal vein occlusions (C/HRVOs).

A comprehensive ophthalmological examination of both eyes including static and dynamic gonioscopy as well as ocular biometric measurements was performed in 57 patients with acute C/HRVOs. The angle configuration and its changes, the axial length of the globe, the anterior chamber depth and the corneal thickness were assessed.

12 C/HRVO patients presented with narrow drainage angles (< or = 20 degrees) and 45 had normal angles (> 20 degrees). Ocular globes with narrow angles had axial length and anterior chamber depth significantly smaller as well as cornea thickness significantly greater than the eyes with normal angles. Out of the 12 patients with narrow angles, 6 cases had primary angle closure suspect (PACS), 5 cases had primary angle closure (PAC) and one case primary angle closure glaucoma (PACG). 3 of the 6 PACS patients progressed to PAC in the 6th, 10th, and 18th months of the follow-up period. From the 8 PAC cases existing during the whole study interval, one case progressed to PACG during the 24th month of the folow-up interval.

In the context of an ocular globe having its size significantly smaller than the normal eye, narrow angle may represent a local risk factor predisposing to C/HRVO. Intermittent episodes of angle closure may contribute by increasing the intraocular pressure to the occurrence of C/HRVO as well to the progression of the gonioscopic configuration from PACS to PAC and from PAC to PACG.