Adrian AuAssaf HilelyJackson ScharfFrederic GunnemannDerrick WangIsmael ChehaibouClaudio IovinoChristelle GrondinMarie Louise FareckiKhalil Ghasemi FalavarjaniNopasak PhasukkijwatanaMarco BattistaEnrico BorrelliRiccardo SacconiBrittany PowellGrant HomTyler E. GreenleeThais F. ContiGerardo Ledesma-GilMehmet Yasin TekeNetan ChoudhryAdrian T. FungValerie KrivosicJiwon BaekMee Yon LeeYoshimi SugiuraGiuseppe QuerquesEnrico PeirettiRichard RosenWon Ki LeeLawrence A. YannuzziDinah ZurAnat LoewensteinDaniel PauleikhoffRishi SinghYasha ModiJean Pierre HubschmanMichael IpSrini Vas SaddaK. Bailey FreundDavid SarrafHazrate Rasoole Akram HospitalVA Greater Los Angeles Healthcare SystemUniversità degli Studi di CagliariThe University of SydneyNYU Grossman School of MedicineHôpital Lariboisiere AP-HPCleveland Clinic FoundationJules Stein Eye InstituteVitreous Retina Macula Consultants of New YorkDoheny Eye InstituteFaculty of Medicine, Siriraj Hospital, Mahidol UniversityUniversità Vita-Salute San RaffaeleNew York Eye and Ear InfirmaryTel Aviv University, Sackler Faculty of MedicineThe Catholic University of KoreaSt. Franziskus-Hospital MünsterVitreous Retina Macula Specialists of TorontoAnkara Ulucanlar Eye Training and Research HospitalNune Eye Hospital2020-08-252020-08-252020-05-01Investigative Ophthalmology and Visual Science. Vol.61, No.5 (2020)15525783014604042-s2.0-85085539603https://repository.li.mahidol.ac.th/handle/20.500.14594/58198Copyright 2020 The Authors PURPOSE. To evaluate the depth and pattern of retinal hemorrhage in acute central retinal vein occlusion (CRVO) and to correlate these with visual and anatomic outcomes. METHODS. Retinal hemorrhages were evaluated with color fundus photography and fluorescein angiography at baseline and follow-up. Snellen visual acuity (VA), central foveal thickness (CFT), extent of retinal ischemia, and development of neovascularization were analyzed. RESULTS. 108 eyes from 108 patients were evaluated. Mean age was 63.6 ± 16.1 years with a predilection for the right eye (73.1%). Average follow-up was 17.2 ± 19.2 months. Mean VA at baseline was 20/126 and 20/80 at final follow-up. Baseline (P = 0.005) and final VA (P = 0.02) in eyes with perivascular nerve fiber layer (NFL) hemorrhages were significantly worse than in eyes with deep hemorrhages alone. Baseline CFT was greater in the group with perivascular hemorrhages (826 ± 394 μm) compared to the group with deep hemorrhages alone (455 ± 273 μm, P < 0.001). The 10 disc areas of retinal ischemia was more common in patients with perivascular (80.0%) and peripapillary (31.3%) versus deep hemorrhages alone (16.1%, P < 0.001). Neovascularization of the iris was more common, although this differrence was not significant, in the groups with peripapillary (14.3%) and perivascular (2.0%) NFL versus deep hemorrhages alone (0.0%). CONCLUSIONS. NFL retinal hemorrhages at baseline correlate with more severe forms of CRVO, with greater macular edema, poorer visual outcomes, and greater risk of ischemia and neovascularization. This may be related to the organization of the retinal capillary plexus. The depth and pattern of distribution of retinal hemorrhages in CRVO may provide an easily identifiable early biomarker of CRVO prognosis.Mahidol UniversityMedicineNeuroscienceArticleSCOPUS10.1167/IOVS.61.5.54