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Abstract：
Purpose: To determine the time-based incidence of total blindness after central retinal artery occlusion (CRAO) with secondary ocular neovascularization (ONV). Methods: In this retrospective cohort study, electronic records were queried using ICD-9 and ICD-10 codes to identify patients with secondary ONV post-CRAO. Patients with possible alternative ONV etiologies, previous panretinal photocoagulation (PRP), and/or previous antivascular endothelial growth factor (anti-VEGF) therapy were excluded. Clinical data included demographics, medical comorbidities, ONV manifestations, medical/surgical management, and best-corrected visual acuity (BCVA). Kaplan-Meier analysis was performed with total blindness (defined as a BCVA of no light perception) as the outcome of interest. Results: Of 345 eyes with CRAO, 34 met the inclusion criteria with a mean (±SD) follow-up of 22.0 ± 26.2 months. ONV management included PRP (70.6%), glaucoma drainage implant surgery or transscleral cyclophotocoagulation (32.4%), and intravitreal anti-VEGF therapy (mean 2.8 ± 5.6 injections per patient). The cumulative incidence of total blindness was 49.4% (95% confidence interval, 27.2%-71.6%) at 24 months, with 53.3% of cases occurring within 4 months of ONV onset. Conclusions: Post-CRAO ONV is associated with a high risk for progression from severe vision loss to total blindness. Neovascular glaucoma can present up to 4 months after CRAO, challenging the paradigm of \"30-day-glaucoma.\" Routine gonioscopy should extend through this period, while glaucoma surgery can delay further vision loss. These findings can be used to counsel patients on the importance of follow-up adherence.
摘要：
目的：确定视网膜中央动脉阻塞（CRAO）伴继发性眼部新生血管（ONV）后全盲的时间发生率。方法：在这项回顾性队列研究中，使用ICD-9和ICD-10代码查询电子记录,以识别CRAO后继发ONV患者.有可能替代ONV病因的患者，既往全视网膜光凝（PRP），和/或既往抗血管内皮生长因子(抗VEGF)治疗被排除.临床数据包括人口统计学，医疗合并症,ONV表现，医疗/外科管理，和最佳矫正视力（BCVA）。以完全失明(定义为无光感知的BCVA)作为感兴趣的结果进行Kaplan-Meier分析。结果：345眼CRAO，34符合纳入标准，平均（±SD）随访22.0±26.2个月。ONV管理包括PRP（70.6%），青光眼引流植入手术或经巩膜睫状体光凝术（32.4%），和玻璃体内抗VEGF治疗（每位患者平均2.8±5.6次注射）。全盲的累积发生率为49.4%(95%置信区间,27.2%-71.6%)在24个月时，53.3%的病例发生在ONV发病后4个月内。结论：CRAO后ONV与从严重视力丧失到完全失明的高风险相关。新生血管性青光眼可在CRAO后4个月出现，挑战“30天青光眼”的范式。“常规的房角镜检查应该持续到这段时间，而青光眼手术可以延缓进一步的视力丧失。这些发现可用于指导患者随访依从性的重要性。
