Abstract
PurposeTo investigate factors associated with poor visual acuity (VA) in branch retinal artery occlusion (BRAO).MethodsThis was a retrospective cross-sectional study of 72 eyes with BRAO of 72 patients. For statistical comparison, we divided the patients into worse-VA (decimal VA < 0.5) and better-VA (decimal VA > = 0.5) groups. We examined the association of clinical findings, including blood biochemical test data and carotid artery ultrasound parameters, with poor VA.ResultsMedian age, hematocrit, hemoglobin and high-density lipoprotein (HDL) differed significantly between the groups (P = 0.018, P < 0.01, P < 0.01, and P = 0.025). There was a tendency towards higher median IMT-Bmax in the worse-VA group (worse-VA vs. better-VA: 2.70 mm vs. 1.60 mm, P = 0.152). Spearman’s rank correlation test revealed that logMAR VA was significantly correlated to IMT-Bmax (rs = 0.31, P < 0.01) and IMT-Cmax (rs = 0.24, P = 0.035). Furthermore, logMAR VA was significantly correlated to HDL level (rs = -0.33, P < 0.01). Multivariate logistic regression analysis revealed that IMT-Bmax (odds ratio [OR] = 2.70, P = 0.049), HDL level (OR = 0.91, P = 0.032), and female gender (OR = 15.63, P = 0.032) were independently associated with worse VA in BRAO.ConclusionsWe found that increased IMT-Bmax, decreased HDL, and female sex were associated with poor VA in BRAO patients. Our findings might suggest novel risk factors for visual dysfunction in BRAO and may provide new insights into the pathomechanisms underlying BRAO.
Highlights
Branch retinal artery occlusion (BRAO), one of the most common retinal vascular disorders, can cause sudden vision loss and visual field defects [1]
Multivariate logistic regression analysis revealed that intima-media thickness (IMT)-Bmax, high-density lipoprotein (HDL) level (OR = 0.91, P = 0.032), and female gender (OR = 15.63, P = 0.032) were independently associated with worse visual acuity (VA) in BRAO
We found that increased IMT-Bmax, decreased HDL, and female sex were associated with poor VA in BRAO patients
Summary
Branch retinal artery occlusion (BRAO), one of the most common retinal vascular disorders, can cause sudden vision loss and visual field defects [1]. The visual prognosis for BRAO is generally better than for central retinal artery occlusion (CRAO) [1], but 40 to 50% of BRAO cases show decimal visual acuity (VA) worse than 0.5 [5, 6]. It has been reported that when VA at presentation is 0.4 or worse, only 25% of BRAO cases improve to a VA of 0.5 or better [5]. Factors associated with the poor prognosis in these cases remain to be determined, systemic conditions associated with atherosclerosis are likely candidates, being well-known risk factors for the development of BRAO. There is a need to identify clinical indicators associated with a poor visual prognosis in BRAO, in order to establish preventive therapy for BRAO and associated decreased visual function
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