The risk of missing angle neovascularization by omitting screening gonioscopy in acute central retinal vein occlusion.

OBJECTIVE: The purpose of the study was to determine whether angle neovascularization can occur without pupillary margin neovascularization in central retinal vein occlusion (CRVO).

DESIGN: The study design was a prospective study of the main question and a retrospective study of ancillary issues.

PARTICIPANTS: The authors examined 105 eyes of 100 patients with CRVO having clinical evidence of ischemia between July 1, 1986, and March 18, 1996.

INTERVENTION: The authors looked for iris and angle neovascularization with both undilated slit-lamp biomicroscopy and Zeiss four-mirror gonioscopy.

MAIN OUTCOME MEASURES: The presence of anterior segment neovascularization was measured.

RESULTS: Of 34 eyes developing anterior segment neovascularization, 4 (12%) developed angle neovascularization without pupillary margin neovascularization over a mean follow-up of 2.2 +/- 2.4 standard deviation years.

CONCLUSIONS: Angle neovascularization can occur without pupillary margin involvement in CRVO, implying the necessity of screening gonioscopy and supporting the Central Vein Occlusion Study conclusion (based on a photographic technique not used clinically).