Abstract |
We investigated prospectively in 128 patients (140 eyes) the role of six routine clinical tests in the differentiation of ischemic central retinal vein occlusion (CRVO) from non-ischemic CRVO during its early acute phase. There were four functional tests [visual acuity, visual fields, relative afferent pupillary defect (RAPD), electroretinography (ERG)] and two morphologic tests (ophthalmoscopy and fluorescein fundus angiography). We found that none of the six tests had 100% sensitivity and specificity in such a differentiation during the early, acute phase, so that no one test can be considered a "gold standard"; however, combined information from all six is almost always reliable. Overall, the four functional tests proved far superior to the two morphologic tests in differentiating ischemic from non-ischemic CRVO:RAPD was most reliable in uniocular CRVO (with a normal fellow eye), followed closely by ERG in all cases; combined information from RAPD and ERG differentiated 97% of cases; perimetry was the next most reliable, followed by visual acuity. The two morphologic tests performed worst; fluorescein angiography provided either no information at all on retinal capillary nonperfusion (in at least one-third of the eyes during the early, acute phase) because of multiple limitations, or sometimes provided misleading information. Ophthalmoscopic appearance is the least reliable, most misleading parameter.
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Authors | S S Hayreh, M R Klugman, M Beri, A E Kimura, P Podhajsky |
Journal | Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie
(Graefes Arch Clin Exp Ophthalmol)
Vol. 228
Issue 3
Pg. 201-17
( 1990)
ISSN: 0721-832X [Print] Germany |
PMID | 2361592
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
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Topics |
- Acute Disease
- Aged
- Aged, 80 and over
- Diagnosis, Differential
- Electroretinography
- Fluorescein Angiography
- Follow-Up Studies
- Fundus Oculi
- Humans
- Ischemia
- Middle Aged
- Ophthalmoscopy
- Predictive Value of Tests
- Prospective Studies
- Pupil Disorders
(diagnosis)
- Retinal Diseases
(diagnosis)
- Retinal Vein Occlusion
(diagnosis, pathology)
- Retinal Vessels
(pathology)
- Visual Acuity
- Visual Fields
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