PROGNOSIS FOR RUBEOSIS IRIDIS FOLLOWING CENTRAL RETINAL VEIN OCCLUSION

The records of 57 patients with recent central retinal vein occlusion were reviewed in order to predict the development of rubeosis iridis (RI) and neovascular glaucoma (NVG) from the initial clinical examination, colour fundus photographs, and fluorescein angiograms. Twelve patients (21 %) developed both RI and NVG, and this complication appeared to be correlated most significantly with clinical and fluoroangiographic evidence of severe retinal ischaemia. The correlation between RI and other findings was as follows: widespread capillary occlusion (86% developed RI); absent perifoveal network (80 %); 10 or more cotton-wool spots (75 %); A-V transit time of greater than 20 seconds (75 %); severe large vessel leakage (31 %); and severe retinal oedema (60 %). Less significant correlation of RI was obtained with poor visual acuity and with associated systemic diseases. Factors of no statistical prognostic value included the patient's age, history, or evidence of pre-existing open-angle glaucoma, degree of fundus haemorrhage, capillary dilatation, disc oedema, disc capillary dilatation and leakage, leakage of small vessels in the posterior pole, and development of disc collateral vessels. Multivariate linear discriminant analysis of the data supported the above factors as being the variables that best predicted the development of RI, and a derived linear equation predicted 91 % of all patients studied who had central retinal vein occlusion and who developed rubeosis iridis.