Population-Based Incidence of Ocular Neovascularization Following Central Retinal Artery Occlusion in Olmsted County, Minnesota

PURPOSE: To determine the population-based incidence of ocular neovascularization (NV) following central retinal artery occlusion (CRAO) and systemic risk factors associated with its development. METHODS: Diagnosis of CRAO between January 1, 1976, and September 9, 2016, was identified using the Rochester Epidemiology Project, a medical records linkage system for all medical care provided to residents of Olmsted County, Minnesota. Records were reviewed to confirm the diagnosis of CRAO, and data were collected on ocular NV and associated systemic diseases. RESULTS: There were 89 patients with CRAO. Subsequent ocular neovascularization developed in 14 (16%) patients. Neovascularization of the iris (NVI) was present in 9/14 (64%) of these patients, neovascularization of the angle (NVA) in 10/14 (71%), neovascularization of the disc (NVD) in 2/14 (14%), and neovascularization elsewhere (NVE) in 1/14 (7%). Of these 14 patients with NV, 9 (64%) developed neovascular glaucoma (NVG). The mean time from CRAO diagnosis to NV was 82 days (range 22 to 268 days). Excluding the patients with proliferative diabetic retinopathy or CRAO caused by CRVO, the mean time to NV diagnosis was 80 days and the shortest time to NV diagnosis was 22 days. Diabetes mellitus was present in 64% of those with NV compared to 23% of those without NV (P = 0.003). CONCLUSION: The population-based incidence of ocular neovascularization following CRAO is 16% and developed within 2 months in half the cohort. Patients with diabetes mellitus are at increased risk for NV complications.