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Purpose: To investigate the incidence of neovascularization of the iris (NVI) and clinical features of patients withNVI following acute central retinal artery occlusion (CRAO). Methods: A retrospective review of 214 consecutive CRAO patients who visited one tertiary hospital betweenJanuary 2009 and January 2015 was conducted. In total, 110 patients were eligible for this study after excludingpatients with arteritic CRAO, a lack of follow-up, iatrogenic CRAO secondary to cosmetic filler injection, orNVI detected before CRAO attack. Fluorescein angiography (FA) was applied until retinal arterial reperfusionwas achieved, typically within 1 to 3 months. Results: The incidence of NVI was 10.9% (12 out of 110 patients). Neovascular glaucoma was found in sevenpatients (6.4%). The mean time to NVI diagnosis after CRAO events was 3.0 months (range, 1 week to 15months). The cumulative incidence was 5.5% at 3 months, 7.3% at 6 months, and 10.9% at 15 months. Severelynarrowed ipsilateral carotid arteries were observed in only three patients (27.3%). The other nine patients(75.0%) showed no predisposing conditions for NVI, such as proliferative diabetic retinopathy or centralretinal vein occlusion. Reperfusion rate and prevalence of diabetes were significantly different between patientswith NVI and patients without NVI (reperfusion: 0% [NVI] vs. 94.7% [no NVI], p < 0.001; diabetes: 50.0%[NVI] vs. 17.3% [no NVI], p = 0.017). Conclusions: CRAO may lead to NVI and neovascular glaucoma caused by chronic retinal ischemia fromreperfusion failure. Our results indicate that follow-up fluorescein angiography is important to evaluate retinalartery reperfusion after acute CRAO events, and that prophylactic treatment such as panretinal photocoagulationshould be considered if retinal arterial perfusion is not recovered.
