Visual Prognosis of Branch Retinal Artery Occlusion

Rod Foroozan, MD


October 01, 2008


Branch retinal artery occlusion (BRAO) accounts for 40% of all retinal artery occlusions, and is most commonly thought to arise from an embolic source.[1] The visual prognosis of BRAO has generally been favorable, and is one reason that treatment options have been limited. Additionally, ocular complications more commonly seen from central retinal artery occlusion (CRAO), such as neovascular glaucoma, are much less likely to be seen in BRAO.

Branch Retinal Artery Occlusion: Visual Prognosis

Mason JO, Shah AA, Vail RS, Nixon PA, Ready EL, Kimble JA
Am J Ophthalmol. 2008;146:455-457

The authors of this retrospective observational study reviewed the records of 52 BRAO patients (29 women) seen at 2 vitreoretinal practices. Only patients with reduced vision and decreased central macular perfusion on fluorescein angiography were included in the study; exclusion criteria included those with cilioretinal artery occlusion and CRAO. Temporal branch arteries were examined in all 52 eyes with BRAO. The relationship between best-corrected visual acuity (BCVA) on presentation and final BCVA was the main outcome measure. Initially, 54% of eyes with BRAO had visual acuity of 20/40 or better. At 14 months, 60% of all eyes had visual acuity of 20/40 or better, and 89% of patients with a baseline BCVA of 20/40 or better retained their visual acuity. Poor visual acuity at baseline was associated with a poor visual outcome; only 14% of eyes with visual acuity of 20/100 or worse improved to 20/40 or better. The presence of visible emboli did not alter the outcome of visual acuity.

The authors of this report noted that patients presenting with BRAO with good visual acuity have a good visual prognosis, a finding that is supported by prior studies on BRAO.[2] Patients with poor initial visual acuities tended to have poor visual outcomes. This finding is important in the development of treatment strategies for BRAO. The study authors suggested that no treatment should be pursued for patients with BRAO because these occlusions are associated with a good visual outcome. The study authors suggested that poor initial visual acuity may provide a reason to initiate more aggressive therapy.



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