Authors:Xie Ting, Li Zhi, Cheng Xiaorong, Wang Weiqing, Li Jin, Liang Siying, Li Wangting, Chen Qingshan
Corresponding author:Chen Qingshan, Email:cqs1967@sina.com
Published:2026-07-10
DOI:10.3760/cma.j.cn115989-20240821-00239
ABSTRACT
Objective To analyze the clinical and imaging features of combined central retinal artery and vein occlusion (CCRAVO) and analyze the correlation with visual acuity improvement.
Methods An observational case series study was conducted. Fifteen patients (15 eyes) diagnosed with CCRAVO in Shenzhen Eye Hospital from December 2018 to May 2023 were enrolled. The best corrected visual acuity (BCVA), color fundus photograph, optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) at baseline and 3 months after treatment were collected. Based on the results of FFA and OCT, 15 patients with CCRAVO were divided into groups according to whether they had paracentral acute middle maculopathy (PAMM) in the inner retinal layer near the central macula or not, with ischemic central retinal vein occlusion (CRVO) or not, and whether they had macular edema or not. differences in various parameters between patients with different types of CCRAVO before and after treatment were compared, and the correlation between clinical and imaging indicators in patients with CCRAVO was analyzed. This study was conducted in accordance with the Declaration of Helsinki. The study protocol was approved by the Ethics Committee of Shenzhen Eye Hospital (NO. 2022-060-01), and written informed consent was obtained from all patients.
Results Color fundus photography of patients with CCRAVO showed tortuous expansion of retinal veins, dotted or patchy retinal hemorrhage, optic disc congestion or edema, cotton wool spots, atypical cherry-red spots, and thin retinal arteries. FFA revealed a prolonged arm to retina circulation time of (16.2±9.2) seconds. OCT showed PAMM and macular edema or serous retinal detachment. PAMM was found in 8 eyes, ischemic CRVO in 4 eyes, and macular edema in 5 eyes. Three months after treatment, BCVA increased, and CRT decreased compared with baseline in the PAMM group and the non-PAMM group, ischemic CRVO group and non-ischemic CRVO group, macular edema group and non-macular edema group, and the differences were statistically significant (all P<0.05). Three months after treatment, there was better BCVA and thicker CRT in the PAMM group than in the non-PAMM group, and there was better BCVA and thinner CRT in the non-ischemic CRVO group than in the ischemic CRVO group and in the non-macular edema group than in the macular edema group (all P<0.05). Baseline central foveal thickness (CRT) was positively correlated with the patients’ disease course ( r=0.533, P=0.041); the change in BCVA after treatment was negatively correlated with endpoint CRT ( r=-0.585, P=0.022); the endpoint CRT was negatively correlated with baseline BCVA ( r=-0.520, P=0.047).
Conclusions In the early stage of CCRAVO, the manifestations of CRAO and CRVO can occur simultaneously, and CRVO may play a more important role in the development of CCRAVO. CCRAVO patients with PAMM, non-ischemic CRVO, and without cystoid macular edema have a better visual prognosis after treatment.
KEYWORDS：
Combined central retinal artery and vein occlusion; Paracentral acute middle maculopathy; Fundus fluorescein angiography; Optical coherence tomography
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Authors Info & Affiliations
Xie Ting
Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, China
Li Zhi
Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, China
Cheng Xiaorong
Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, China
Wang Weiqing
Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, China
Li Jin
Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, China
Liang Siying
Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, China
Li Wangting
Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, China
Chen Qingshan
Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, China
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