Retrospective study of threshold time for the conventional treatment of branch retinal artery occlusion

Abstract

Purpose: To investigate the medical backgrounds of patients and the treatment periods from the onset of branch retinal artery occlusion to obtaining improved final visual acuity.

Methods: This was a retrospective case series study. A total of 68 consecutive patients (69 eyes) with branch retinal artery occlusion who visited Tokyo Medical University Hospital from 2007 to 2012 were included in this study. All patients underwent ophthalmic examinations and visual acuity tests. We reviewed their medical records for systemic conditions, as well as the periods from onset of symptoms to treatment. Participants were categorized into 2 groups: group A (n=36), which received any treatment within 24 hours from onset, and group B (n=33), which visited our hospital after 24 hours from onset. Best corrected visual acuity (BCVA) changes from the first to final visit and the relationships between systemic condition and visiting time to BCVA were assessed.

Results: At the first visit, 59% of the patients had BCVA over 20/40; the ratio was increased to 74% at the final visit. BCVA improved more than 2 lines for 35% of the patients and was unchanged for 57% of those receiving conventional treatment. BCVA over 20/40 was significantly lower in hyperlipidemia patients. Hypertension, diabetes mellitus, and significant carotid stenosis were not correlated. The mean BCVA at baseline (0.91±1.03) significantly recovered to 0.35±0.91 after treatment in group A (P<0.001, Student's t-test). The mean BCVA at baseline (0.30±0.64) was 0.25±0.61 at the final visit in group B (no significant change).

Conclusion: Conventional treatment within 24 hours from onset was acceptable for branch retinal artery occlusion.

Keywords: BRAO; branch retinal artery occlusion; golden period; treatment time.

Figure 1

Best corrected visual acuity before and after treatment. Notes: (A) Mean best corrected visual acuity at baseline (0.91±1.03) significantly recovered to 0.35±0.91 after treatment in group A (P<0.001, Student’s t-test). (B) In contrast, the mean best corrected visual acuity at baseline (0.30±0.64) was not significantly different from the mean best corrected visual acuity at the final visit (0.25±0.61) in group B (P=0.35, Student’s t-test).

Figure 2

Ratio of best corrected visual acuity change (0.2 logMAR) before and after treatment. Notes: Best corrected visual acuity improved by more than 2 lines in 58% of patients in group A. The ratio of gain was significantly higher in the patients in group A than in the patients in group B (12%).