{Reference Type}: Journal Article
{Title}: Visual outcomes and prognostic factors in ischaemic retinal vasculitis.
{Author}: Yap A;Kearns H;Sims JL;Niederer RL;
{Journal}: Br J Ophthalmol
{Volume}: 0
{Issue}: 0
{Year}: 2024 Aug 1
{Factor}: 5.908
{DOI}: 10.1136/bjo-2024-325775
{Abstract}: <B>OBJECTIVE: </B>Our aim was to describe the visual outcomes and determine the clinical factors in ischaemic retinal vasculitis (IRV) that were predictive of a poor visual prognosis or infectious aetiology.<BR><B>METHODS: </B>Retrospective cohort study of consecutive presentations of IRV to Auckland District Health Board from 2009 to 2022.<BR><B>RESULTS: </B>The median age at presentation was 39.2 years and 108 (53.7%) were women. The total median follow-up was 4.8 years. Infectious aetiology was present in 151 eyes (52.1%). Moderate visual loss (20/50 to 20/200) occurred in 20 eyes (6.9%) and severe visual loss (≤20/200) occurred in 41 eyes (14.1%). Median visual acuity was 20/30 (IQR 20/25 to 20/100) on presentation and 20/25 (IQR 20/20 to 20/50) at final follow-up. Retinitis (HR 4.675 p=0.048) and cystoid macular oedema (CME) (HR 7.265 p<0.001) were significantly associated with vision loss. There was concurrent macular ischaemia in 26 eyes (19.4%) and CME in 52 eyes (17.9%). Retinitis was predictive of infectious aetiology (p=0.006) and cotton wool spots for non-infectious aetiology (p<0.001). Retinal haemorrhage (HR 5.580 p=0.001), retinal vein occlusion (HR 5.071 p=0.001) and quadrants of ischaemia (HR 2.222 p=0.025) were significantly associated with vitreous haemorrhage.<BR><B>CONCLUSIONS: </B>In patients with IRV, 21% of affected individuals sustained moderate-to-severe vision loss over 5 years. Ultra-widefield fluorescein angiography can be used to quantify the risk of neovascular complications and guide treatment.