Retinal Vein Occlusion Clinical Trial
To determine whether photocoagulation therapy can help prevent iris neovascularization in
eyes with central vein occlusion (CVO) and evidence of ischemic retina.
To assess whether grid-pattern photocoagulation therapy will reduce loss of central visual
acuity due to macular edema secondary to CVO.
To develop new data describing the course and prognosis for eyes with CVO.
Central vein occlusion is a common retinal vascular disorder with potentially blinding
complications. The two major complications are reduced central vision caused by macular
edema and neovascular glaucoma caused by iris neovascularization. Other clinical trials have
shown that laser photocoagulation is an effective treatment for complications found in
diabetic retinopathy and branch vein occlusion, which have some features in common with CVO:
neovascularization and reduced visual acuity caused by macular edema occur in all three
disorders. Evidence from small-scale studies suggests that a grid pattern of
photocoagulation reduces macular edema in CVO patients, although the associated changes in
visual acuity are variable. The CVOS is a detailed investigation of grid pattern
photocoagulation in a larger randomized group of patients.
Eligible patients were divided into four groups:
Group N: Eyes with extensive retinal ischemia (at least 10 disc areas of nonperfusion) were
randomly assigned to receive panretinal photocoagulation or nontreatment unless iris
neovascularization developed.
Group M: Eyes with visual loss ascribable to macular edema were randomly assigned to receive
grid-pattern photocoagulation or nontreatment.
Group P: Eyes with relatively perfused retinas were followed to provide information about
the natural history of the disease.
Group I: Indeterminate eyes in which the retina could not be visualized accurately because
of hemorrhage were followed in a natural history study.
Green argon laser with a slit lamp delivery system was used for all treatments. Photographic
documentation of retinal changes was obtained at entry, post-treatment, and at specified
followup visits for a period of at least 3 years. The frequency of followup visits varied
according to the group to which the CVO patient was assigned. Visual acuity, the primary
outcome factor in the group with macular edema, was measured according to a modified Early
Treatment Diabetic Retinopathy Study protocol at each visit.
;
Allocation: Randomized, Primary Purpose: Treatment
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