Patient Age May Impact Retinal Vein Occlusion Rehabilitation, Visual Outcomes

Photo Essay From The University Hospital Of Bordeaux. Cardiologic Hospital Of Haut Leveque. Department Of Diabetology. Examination Of Retinography For The Screening Of Diabetic Retinopathy. (Photo By BSIP/UIG Via Getty Images)
A study shows younger patients have more rapid, better reconstruction of retinal perfusion.

Age appears to be a key factor in retinal vein occlusion (RVO) prognosis, with younger patients achieving more rapid rehabilitation of deep retinal vasculature than older patients, possibly enhancing final vision, according to a study in BMC Ophthalmology.

The retrospective study was designed to compare retinal microvasculature changes in 2 groups of patients with RVO following anti-vascular endothelial growth factor (VEGF) treatment. It divided patients into groups based on age: 20 eyes of 20 patients who were 50 years old and younger (38.3±7.7, range: 22 to  50 years), and 46 eyes of 46 patients who were older than 50 years old (63.0±6.7, range: 52 to 85 years). All patients underwent anti-VEGF injections, with optical coherence tomography angiography (OCT-A) images taken at each visit. Researchers measured and compared best corrected visual acuity (BCVA), vessel density (VD) and foveal avascular zone (FAZ) between the groups, correlating visual improvements and retinal microvasculature changes.

Investigators found that, 12 months after the first anti-VEGF treatment, patients in the younger group had better BCVA, higher VD, and smaller FAZ than patients in the older group. 

“The improvement of VD was observed only in the younger group. A positive correlation between vision improvement and VD increase was noted,” the study shows.

The study’s limitations included its retrospective design, small number of patients, and limited OCTA field of view for analyzing. The loss of follow-up months after the first anti-VEGF treatment, thanks to fast visual recovery, also might’ve introduced bias. And “some BRVO patients were not enrolled in the study due to lack of macular involvement or loss of follow-up after achieving a satisfied vision, leading to the unnatural rate of BRVO to CRVO patients in this study.”


Ye P, Zhu T, Zheng F, et al. Microvascular comparison in younger and older patients with retinal vein occlusion analyzed by OCT angiography. BMC Ophthalmol. 2021;21(1):161. doi:10.1186/s12886-021-01931-5