So-called "central retinal vein occlusion". II. Venous stasis retinopathy.

28 patients (29 eyes) with venous stasis retinopathy (VSR) were studied. This study indicates that VSR is a self-limited, chronic and comparatively benign condition as compared to hemorrhagic retinopathy. No patient with VSR progressed to hemorrhagic retinopathy. The main complication which required management in VSR was the deterioration of central visual acuity (VA) due to development of macular edema which, if untreated, ended in cystoid macular degeneration and permanent central scotoma. Thus the indication for treatment in these cases was the fall of central VA. Ten eyes showed no deterioration of vision throughout follow-up (group I) and hence required no treatment. The remaining 19 eyes developed deterioration of vision: 5 eyes (4 patients) amongst these were not treated (group II) while the other 14 eyes (group III) were treated by systemic corticosteroids, to control the macula edema starting with a dose of 40-60 mg of oral prednisolone daily and gradually tapering to a maintenance dose. The results of group III cases strongly suggested that adequate doses of systemic steroids have a distinct beneficial effect on the VA -they help to prevent deterioration of vision and in the recovery of deteriorated vision. However, these patients require therapy for months or even longer during the course of VSR; on stopping the therapy, poor VA recurred in ten of these eyes. This factor may limit the usefulness of this therapy, if contraindications to such prolonged steriod therapy or serious side-effects of steroid therapy exist in a patient. In such cases one may be confronted with the dilemma of either not treating them and running a fairly high risk of permanent loss of central vision, or treating them with adequate doses of systemic steriods, retaining good VA but running the risk of side effects. While evaluating the effectiveness of steroid therapy, the improvement in VA should be the primary criterion because the fundus appearances almost always show no significant improvement for weeks although the VA rapidly returns to a normal level.