Abstract
Purpose
To evaluate factors associated with the diagnosis of open-angle glaucoma (OAG) after a retinal vein occlusion (RVO).
Design
Retrospective, cross-sectional study.
Methods
Patients diagnosed with OAG after RVO were matched 2:1 with RVO patients without prior glaucoma. Logistic regression identified factors linked to OAG diagnosis.
Results
Of 1178 RVO patients without initial OAG, 51 (4.5%) were later diagnosed with OAG after an average of 5.5 ± 6.1 years. Screening tests for OAG were performed at a higher frequency in patients diagnosed with OAG compared with patients who never received this diagnosis (visual field [VF] testing 21.6% versus 10.8% (P = 0.073) and retinal nerve fiber layer [RNFL] imaging 52.9% versus 27.4% (P = 0.002), respectively). At the time of the first VF obtained after RVO, mean deviation averaged –10.3 dB in the affected eyes, compared with –5.0 dB in the fellow eyes (P < 0.001); in contrast, RNFL thickness was similar between eyes at the time of OAG diagnosis (72 µm versus 74 µm, P = 0.290). Predictive factors for OAG diagnosis included higher intraocular pressure (IOP) and cup-to-disc ratio (CDR) in the unaffected eye, and the absence of macular edema in the RVO-affected eye (R2 = 0.375, P < 0.001).
Conclusions
OAG is a significant risk factor for RVO. Our study reveals a reciprocal relationship between RVO and the development of OAG, highlighting the need for glaucoma risk assessment in all patients with RVOs to avoid delays in diagnosis and vision loss from glaucoma.
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Data availability
The datasets generated during and/or analyzed during the current study are not publicly available due to the nature of this research, as participants of this study did not agree for their data to be shared publicly but are available from the corresponding author on reasonable request.
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Acknowledgements
The authors thank Dr. Shiyoung Roh, Dr. Paul R. Cotran, Dr. Michael L. Cooper, Dr. Haohua Qian, Dr. Kathryn M. Ramsey, Hilcia M. Downs, as well as Carol Spencer, Lahey Hospital Librarian, for research support. D.J. Ramsey was supported by the Harry N. Lee Family Chair in Innovation at the Lahey Hospital & Medical Center, Beth Israel Lahey Health. Manuscript is derived from presentations: “Delay in Diagnosis of Glaucoma after Retinal Vein Occlusion,” presented at the 2023 American Glaucoma Society (AGS) Annual Meeting, Austin, TX, and “Delay in Screening Risks Underdiagnosis of Open-angle Glaucoma in Patients with Retinal Vein Occlusions,” presented at the 2023 Association for Research in Vision and Ophthalmology (ARVO) Annual Meeting, New Orleans, LA.
Funding
DJR: Supported by the Harry N. Lee Family Chair in Innovation, Lahey Hospital & Medical Center, Beth Israel Lahey Health, Peabody, MA.
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DJR was responsible for the study hypothesis and design, the development of electronic medical record reporting tools, reviewing and analyzing the data, interpreting the results, and writing of the manuscript. REM was responsible for the chart review, extracting and analyzing the data, figure development, and writing of the manuscript. AH was responsible for the chart review, extracting and analyzing the data, and writing of the manuscript. AMA was responsible for the chart review, extracting and analyzing the data, and writing of the manuscript.
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Muhtaseb, R.E., Huther, A., Alwreikat, A.M. et al. Optimizing open-angle glaucoma risk assessment in patients with retinal vein occlusions. Eye 38, 2985–2991 (2024). https://doi.org/10.1038/s41433-024-03205-y
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DOI: https://doi.org/10.1038/s41433-024-03205-y
