Fluorescein angiography and its prognostic significance in central retinal vein occlusion

To determine the prognostic value of fluorescein angiograms in central retinal occlusion 75 patients presenting within the first three months of their initial visual symptoms were studied prospectively. The prognosis was found to be best (complete or partial resolution) in eyes with good capillary perfusion, an intact perifoveal capillary arcade, and leakage only from terminal venules and veins. A broken perifoveal capillary arcade and much capillary leakage, even in the absence of obvious capillary closure, were precursors of permanent macular oedema. All eyes with extensive capillary closure developed severe complications such as thrombotic glaucoma and neovascularization (pre-retinal fibrosis), and all became blind. Macular transit time and leakage from arteries and veins were not used as prognostic features. Fluorescein angiography during the first month of the initial visual symptoms was of prognostic value only in those cases with poor prognosis. The three-month angiogram was an accurate indicator of the visual outcome in all cases.