A randomised prospective study of treatment of non-ischaemic central retinal vein occlusion by isovolaemic haemodilution.

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Abstract
In a randomised study 25 patients over 50 patients over 50 years of age with non-ischaemic central retinal vein occlusion (CRVO) were assigned to either a treatment (14 patients, isovolaemic haemodilution) or a control group (11 patients, no treatment). After three months eight eyes in patients with haemodilution improved, whereas none of the untreated eyes had better visual acuity (p < 0.01). Thirteen haemodiluted and 11 control patients could be observed for one year. Six eyes of the haemodiluted patients retained a better visual acuity, whereas no improvements had occurred in the control group (p < 0.025). In fluorescein angiography the lowering of the packed cell volume to 25-32% accelerated the time of maximal venous filling (tmf) from 17.4 (SEM 1.4) s to 11.4 (SEM 0.9) s (p < 0.005). In patients with non-ischaemic CRVO without treatment the passage time did not change. The shortened tmvf reflects a higher blood velocity. Thus isovolaemic haemodilution improves the visual prognosis in non-ischaemic CRVO probably by inducing a higher blood fluidity, which results in higher blood velocity, at least in areas of compromised retinal microcirculation.