This document summarizes a study on assessing the prevalence of glaucoma in the fellow eyes of patients with unilateral retinal venous occlusion. The study examined 54 patients with retinal vein occlusion and evaluated their fellow eyes. The results found that 26% of fellow eyes had glaucoma, with the prevalence being significantly higher in central retinal vein occlusion patients compared to branch retinal vein occlusion patients. Elderly patients and those with ischemic central retinal vein occlusion were more likely to have glaucoma in the fellow eye. The conclusion is that screening for glaucoma in the fellow eye of patients with unilateral venous occlusion is important to detect previously unidentified glaucoma cases.

1. Silent Killer Next door :
Beware of Glaucoma
Presenting Author :
Dr Rahul Achlerkar
Co-Authors :
Dr.Rita Dhamankar
Dr . Vijay Shetty
Dr. Sachin Fegde

2. Introduction
 Patients with retinal venous occlusion do have a poor visual
outcome
 We would certainly like to avoid progression of disease like
glaucoma in such patients which results in irreversible
blindness by diagnosing it early.
 In many cases, perimetry cannot be performed in the affected
eye because of poor vision.
 In cases where perimetry can be performed, field changes due
to the vascular occlusion itself may mask glaucomatous
changes.

3. AIM
 To asses the prevalence of glaucoma in fellow eyes of patients
with unilateral venous occlusion
 To study the clinical features of glaucoma in these eyes.

4. Methodology:
 This is Cross-sectional study of 54 patients with retinal venous
occlusion .
 Fellow apparently-normal eye evaluated by applanation
tonometer ,Gonioscopy, perimetry, Oct.
 Depending on clinical features Venous occlusion further
classified into central & branched venous occlusion . Ischemic
& non ischemic central venous occlusion

5. Full description of the study design, methods
and procedures:
 Study site Laxmi Eye Institute , Panvel
 Study design – prospective cross sectional study
 Sample size - 54 eyes with unilateral vein occlusion
 Sampling – consecutive consenting

6. Inclusion criteria
 All Patients with unilateral retinal venous occlusion
EXCLUSION CRITERIA:
 Known case of glaucoma
 Patients with rubeosis in fellow eye
 cases where perimetry could not be done in unaffected eye due
to other causes

7. Results:
 The mean age of our population 60.30 yrs, 57% males, 43%
females
 The prevalence of glaucoma in fellow eyes was 26% (95%
confidence intervals [CI]: 15%-40%);
 most common type POAG 69.33 %.

8. Results:
 The prevalence was
significantly higher in
CRVO patients compared
with BRVO patients (48% vs
7%, p=0.001)
44
7
0
5
10
15
20
25
30
35
40
45
50
CRVO BRVO
%
p=0.01
Odds Ratio (OR) unadjusted 9.8(CI 1.5 -50.7)

9. Results:
 Even after adjusting for age and sex, fellow eyes of CRVO
were significantly more likely to have glaucoma compared
with BRVO (OR: 12.9; 95% CI: 2.1 to 79.5)
 Among CRVO, ischemics were likely to have glaucoma
compared with non-ischemics (77% vs 33%, p=0.07).

10. Results
 Patients more than 75 years
and 61-75 years were more
likely to have glaucoma
compared with those
between the ages of 25 and
60 years.
8
39
50
0
10
20
30
40
50
60
<61 61-75 >75
%
P=0.02
(OR: 14.8, 95% CI: 1.1 to >200)
(OR: 7.3, 95% CI: 1.1-48.9)

11. Conclusion:
 We found a significant number of previously undetected
glaucomas in our study
 Patients with unilateral venous occlusion shows preponderance
of glaucoma in fellow eye
 Among CRVO, ischemics were likely to have glaucoma
compared with non-ischemics
 Elderly CRVO patients were most likely to have glaucoma in
fellow eyes.
 Glaucoma screening of the normal eye is mandatory in persons
with unilateral venous occlusion

12. References
1. Verhoeff FH. The effect of chronic glaucoma on the central
retinal vessels. Arch Ophthalmol 1913; 42: 145-152.
2. Leber T. Die Krankheiten der Netzhaut. In: Graefe AC,
Saemisch ET, Hess C, Eds. Handbuch der Gesammten Augen
heilkunde. 2nd Ed. Leipzig: Wilhelm Engelmann; 1915; 355.
3. Vadala G, Zanini A, Favero C, et al. Evaluation of the clinical
course of Central Retinal Vein Occlusion in eyes with and
without glaucoma. Acta Ophthalmol Scand. 1997; suppl 224:
16-17.
4. Saatchi OA, Ferliel ST, Ferliel M, et al. Pseudoexfoliation and
glaucoma in eyes with retinal vein occlusion. Int Ophthalmol
1999; 23: 75-78.

13. Thank you