The risk of missing angle neovascularization by omitting screening gonioscopy in acute central retinal vein occlusion

The purpose of the study was to determine whether angle neovascularization can occur without pupillary margin neovascularization in central retinal vein occlusion (CRVO).

The study design was a prospective study of the main question and a retrospective study of ancillary issues.

The authors examined 105 eyes of 100 patients with CRVO having clinical evidence of ischemia between July 1, 1986, and March 18, 1996.

The authors looked for iris and angle neovascularization with both undilated slit-lamp biomicroscopy and Zeiss four-mirror gonioscopy.

The presence of anterior segment neovascularization was measured.

Of 34 eyes developing anterior segment neovascularization, 4 (12%) developed angle neovascularization without pupillary margin neovascularization over a mean follow-up of 2.2 +/- 2.4 standard deviation years.

Angle neovascularization can occur without pupillary margin involvement in CRVO, implying the necessity of screening gonioscopy and supporting the Central Vein Occlusion Study conclusion (based on a photographic technique not used clinically).