Observational studyJapanese journal of ophthalmology2026
Branch retinal vein occlusion in Leber hereditary optic neuropathy with onset at age 50 years or older: frequency and clinical characteristics.
Observational study in Japanese journal of ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo describe branch retinal vein occlusion (BRVO) observed in patients with Leber hereditary optic neuropathy (LHON) with onset at age ≥50 years and to explore whether BRVO prevalence may be higher than age- and sex-matched general population estimates. STUDY
designRetrospective observational study.
methodsWe reviewed 187 genetically confirmed LHON patients seen at a single center (1990-2024) and analyzed 39 patients with LHON onset at age ≥50 years. We summarized fundus findings, management, and longitudinal visual function. We also performed indirect standardization using age- and sex-specific BRVO point prevalence from the Hisayama Study to calculate the standardized prevalence ratio (SPR) for BRVO diagnosed before LHON onset; a sensitivity analysis used an ever-BRVO definition that also included post-onset cases.
resultsFour patients had BRVO. Three cases were diagnosed before LHON onset (SPR 3.88; 95% CI 0.80-11.34), and inclusion of one post-onset case increased the SPR to 5.17 (95% CI 1.41-13.25). Macular atrophy was present in two patients. All patients underwent laser photocoagulation and none received intravitreal anti-vascular endothelial growth factor (VEGF) therapy. Longitudinal visual function generally showed persistent central visual field loss consistent with LHON, with some BRVO-affected eyes demonstrating additional nasal or inferonasal components at follow-up.
conclusionIn this older-onset LHON cohort, BRVO was observed in four patients and detailed case-level characteristics are presented. The indirect standardized comparison suggests a tendency toward higher standardized BRVO prevalence; however, this prevalence-based analysis is not adjusted for vascular risk profiles and should be interpreted as hypothesis-generating.
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