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Clinical and demographic profile, systemic risk factors, and visual prognosis in branch retinal vein occlusion: Analysis of big data study
*Corresponding author: David Aggarwal, Anant Bajaj Retina Institute, LV Prasad Eye Institute, Vijayawada, Andhra Pradesh, India. davidaggarwal@gmail.com
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Received: ,
Accepted: ,
How to cite this article: Aggarwal D, Kadam YP, Das A, Takkar B, Narayanan R. Clinical and demographic profile, systemic risk factors, and visual prognosis in branch retinal vein occlusion: Analysis of big data study. IHOPE J Ophthalmol. doi: 10.25259/IHOPEJO_7_2025
Abstract
Objectives:
This study aimed to characterize the clinical and demographic profile, risk factors, and outcomes of branch retinal vein occlusion (BRVO).
Materials and Methods:
This hospital-based, multicenter, and retrospective study analyzed data from patients diagnosed with BRVO between August 2010 and June 2021. Patients with BRVO in at least one eye were included, and data were collected using an electronic medical record system.
Results:
A total of 13,667 patients (14,581 eyes) were diagnosed with BRVO, representing 0.48% of the total patient population. The majority were male (57.80%) and had unilateral involvement (93.31%). The most common age of presentation was during the 6th (31.35%) and 7th (31.57%) decades of life. The prevalence was higher in patients from urban areas (0.59%). Among patients younger than 40 years, dyslipidemia (Odds ratios [OR]: 13.36; 95% confidence interval [CI]: 6.33–28.18) and hyperhomocysteinemia (OR: 25.97; 95% CI: 9.66–69.8) were strongly associated with BRVO. In patients older than 40 years, hypertension (HTN) (OR: 1.33; 95% CI: 1.27–1.39) and diabetes mellitus (DM) (OR: 1.26; 95% CI: 1.2–1.32) were the most significant risk factors. The mean presenting visual acuity was logarithm of minimum angle of resolution (log MAR) 0.70 ± 0.70, which improved to 0.50 ± 0.50 at the final visit. The most common ocular comorbidities included cataracts (18.60%), vitreous hemorrhage (5.52%), and glaucoma (4.73%). Intravitreal injections were administered to 25.66%, vitrectomy was performed in 3.35%, and glaucoma surgery was performed in 0.34% eyes.
Conclusion:
Systemic comorbidities such as HTN, DM, dyslipidemia, and hyperhomocysteinemia showed strong associations, particularly in different age groups. Despite moderate visual impairment at presentation, timely interventions contributed to meaningful visual improvement in a significant number of patients.
Keywords
Big data
Branch retinal vein occlusion
Electronic medical records
India
INTRODUCTION
Branch retinal vein occlusion (BRVO) is a common retinal vascular disorder characterized by the blockage of the venous blood flow in the retina, typically at the site where a retinal artery crosses and compresses a vein.[1,2] This obstruction disrupts normal blood circulation and may lead to clot formation, further exacerbating the condition.[3-5] BRVO is categorized based on its anatomical position into two types: Major and macular. Major BRVO involves the blockage of a vein that drains one of the retinal quadrants. macular BRVO is characterized by the obstruction of a small venule within the macula.[1,2]
Globally, BRVO is the most prevalent type of retinal vein occlusion, with an incidence rate ranging between 0.44% and 1.68%.[3-6] Its prevalence varies by ethnicity: 0.28% in Caucasian populations, 0.35% in African descent, 0.49% in Asian groups, and 0.59% in Hispanic communities.[7,8] Advanced age, hypertension (HTN), diabetes mellitus (DM), dyslipidemia, raised intraocular pressure, and glaucoma are established risk factors for BRVO.[7] The most common cause of vision loss in BRVO patients is macular edema, which often responds well to treatments with anti-vascular endothelial growth factor (anti-VEGF) or steroid injections, resulting in favorable visual and anatomical results.[8]
Despite the growing body of research on BRVO, there is a notable lack of literature focusing on its clinical patterns, demographic distribution, and treatment outcomes in the Asian subcontinent, particularly within the Indian population.[9] India’s diverse demographics provide a unique opportunity to explore the disease’s clinical profile and outcomes in greater depth. In addition, studies involving large cohorts or BRVO patients younger than 40 years are scarce in the existing literature.[10] This study aims to address these gaps by evaluating the clinical characteristics, demographic patterns, and visual outcomes of BRVO in a cohort of over 13,000 cases across all age groups in the Asian subcontinent. The findings are expected to enhance the understanding of BRVO in this population and provide valuable insights into its real-world management.
MATERIAL AND METHODS
Study design, period, location, and approval
This network-wide, multicenter, retrospective, and hospital-based study included all patients presenting to a multitier eye care network in India between August 2010 and June 2021. The network comprised 24 secondary and four tertiary centers in one eastern and three southern states in India.[11] The patient filled out a standard consent form for electronic data privacy at the time of registration. None of the identifiable patient parameters were used in the data analysis. The clinical data of each patient who underwent a comprehensive ophthalmic examination were entered into a browser-based electronic medical records (EMR) system (eyeSmart EMR) by uniformly trained ophthalmic personnel, finally supervised by an ophthalmologist using a standardized template. Only patients diagnosed in the retina clinic (headed by usually 20–25 senior retina faculty, across the network) were included.[12] The study adhered to the principles of the Declaration of Helsinki and was approved by the Institutional Ethics Committee (LEC-BHR-R-08-21-740).
Cases
A total of 2,834,616 new patients presented to the tertiary and secondary centers of the multi-tier ophthalmology network during the study period. In this study, BRVO cases were identified using the International Classification of Diseases (ICD) coding system recorded in the EMR. The branch retinal vein is recognized by the H34.83 ICD code. The eyeSmart EMR was screened for patients with a documented ocular diagnosis of “branch retinal vein occlusion” or BRVO in one or both eyes. A total of 13,667 patient records were identified using this search strategy and were labeled as cases. A total of 14581 eyes had a diagnosis of BRVO and were further analyzed for clinical information. Diagnosis of BRVO was confirmed by retinal specialists (ophthalmologists) based on fundus examination. Patients with hazy media, such as cataract and vitreous hemorrhage (VH), may not have had their diagnosis confirmed and may have been excluded from the study.
Data retrieval and processing
The dataset was derived from hospital-based EMRs, and a trained retinal specialist confirmed all diagnoses. The data were segregated into an Excel sheet. The columns included the data on patient demographics, clinical presentation, ocular diagnosis, and treatment information and were exported for analysis. Variables included patient demographics such as age, gender, systemic comorbidities like HTN/DM, clinical presentation, ocular diagnosis, and treatment information. Data entry was done by trained personnel, including ophthalmologists and optometrists. Systemic comorbidities were documented in the electronic records by the supervising ophthalmologist. Patients with pre-existing diagnoses of systemic comorbidities under the care of a treating physician were categorized accordingly during their first visit. For other patients, we have an internal medicine department within the premises, which is EMR integrated, and blood investigations are conducted by the in-house physician. Those exceeding the cutoff values, as described in the literature, were subsequently classified into appropriate systemic comorbidity categories.[13-17] The test results and physician notes were also entered into the EMR database. The Excel sheet with the required data was then used for analysis using the appropriate statistical software.
The categorization of the districts of India was performed in accordance with the National Sample Survey Organization, which defines “rural” as an area with a population density of up to 400/km2.[11] The Constitution (74th Amendment) Act, 1992, defines a metropolitan area in India as an area having a population of 1 million or more, comprised in one or more districts and consisting of two or more municipalities or panchayats or other contiguous areas, specified by the Governor by public notification to be a metropolitan area. The remaining districts were classified as urban.[18] The visual acuity was classified according to the WHO guidelines: Normal vision (≥6/18), moderate visual impairment (<6/18–6/60), severe visual impairment (<6/60–3/60), and blindness (<3/60).[19] The average number of follow-up visits and the average number of days’ difference from the first and final visit were calculated.
Statistical analysis
Descriptive statistics, including the mean, median, standard deviation, interquartile range (IQR), and proportion (data distribution), were employed to characterize the study population. Frequency data for various variables were compiled using Microsoft Excel 2013. The Chi-square test (StataCorp. 2015. Stata Statistical Software: Release 14. College Station, TX: StataCorp LP) was employed for univariate analysis to identify significant differences in the distribution of demographic characteristics between patients with BRVO and the overall population, as well as to examine disease severity across secondary and tertiary centers. Multiple logistic regression analysis was conducted to evaluate the impact of comorbidities on vision. Independent variables such as presenting age, glaucoma, primary open-angle glaucoma, epiretinal membrane, hypertensive retinopathy, cataract, macular hole, and presenting visual acuity (PVA) were analyzed, with final visual acuity (FVA) serving as the dependent variable. Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated using R software (version 3.5.1) to identify the prominent systemic risk factors in the age groups <40 years and >40 years. P<0.05 was considered statistically significant.
RESULTS
Prevalence
Of the 2,834,616 patients who presented across the eye care network during the study period, 13,667 patients were diagnosed with BRVO in at least one eye, a sample prevalence of 0.48%.
Age distribution
The mean age of the patients was 58.70 ± 11.23 years, while the median age was 60 (IQR: 25–75, range: 15–100 years). The most common age group of the patients was distributed between 51–60 years (n = 4284; 31.35%) and 61–70 years (n = 4315; 31.57%). The prevalence of BRVO increased with age (31–40 years: 0.19%; 41–50 years: 0.51%; 51–60 years: 0.88%; 61–70 years: 0.9%; >70 years: 1.01%). Age-matched BRVO-based proportions for DM and HTN are shown in Figure 1.
- Age-wise distribution of diabetes mellitus and hypertension in patients with branch retinal vein occlusion. DM: Diabetes mellitus, HTN: Hypertension, BRVO: Branch retinal vein occlusion.
Gender distribution
There were 7900 (57.80%) males and 5767 (42.20%) females with BRVO. The overall prevalence of BRVO across our EMR data was significantly greater in males (0.51%; 7900/1527876) as compared to females (0.44%; 5767/1306740), and this difference was statistically significant (P < 0.00001). The distribution was calculated by determining the proportion of males and females with BRVO among the total number of males and females screened in the network during the study period. Among the patients diagnosed with BRVO, the mean age was 58 ± 11.68 (IQR: 25–75) years, and 58.42 ± 10.56 (IQR: 25–75) years for men and women, respectively.
Urban-rural distribution
Of the 13,667 patients with BRVO, 6,609 (48.36%) patients were from the urban locality, 5,139 (37.60%) were from rural locality, and 1,919 (14.04%) patients presented from the metropolitan region. The overall prevalence of BRVO in the urban community (0.59%; 6609/1106990) was higher compared to the rural (0.38%; 5139/1353226) and metropolitan communities (0.51%; 1919/374400), and this difference was statistically significant (P ≤ 0.00001).
Systemic comorbidities associated with BRVO
The most common systemic factors associated with BRVO were HTN in 2617 (19.15%) and DM in 2238 (16.38%) patients. The distribution of associated systemic diseases in patients with BRVO in the cohort is mentioned in Table 1. The OR of systemic risk factors in BRVO for <40 years and more than 40 years of age are mentioned in Table 2. It was observed that dyslipidemia (OR: 13.36; 95% CI: 6.33–28.18) and hyperhomocysteinemia (OR: 25.97; 95% CI: 9.66–69.8) were significant risk factors in BRVO patients (P < 0.0001) in patients with age <40 years. In patients with age above 40 years, apart from dyslipidemia (OR: 18.24; 95% CI: 15.37– 21.63) and hyperhomocysteinemia (OR: 11.8; 95% CI: 8.07– 17.26); HTN (OR: 1.33; 95% CI: 1.27–1.39) and DM (OR: 1.26; 95% CI: 1.2–1.32) were also significant risk factors.
| Systemic disease | Number | Proportion (%) |
|---|---|---|
| DM | 2238 | 16.38 |
| HTN | 2617 | 19.15 |
| DM-HTN | 979 | 7.16 |
| Coronary artery disease | 364 | 2.66 |
| Thyroid | 327 | 2.39 |
| Cholesterol/dyslipidemia | 158 | 1.16 |
| Hyperhomocystenemia | 33 | 0.24 |
| Coronavirus disease of 2019 | 5 | 0.04 |
DM: Diabetes mellitus, HTN: Hypertension
| Systemic risk factors | Odds ratio with 95% CI for (<40 years) lower CI–upper CI, P-value | Odds ratio with 95% CI for (>40 years) lower CI–upper CI, P-value |
|---|---|---|
| Diabetes mellitus | 0.48; (0.37–0.63), P<0.0001 | 1.26; (1.2–1.32), P<0.0001 |
| Hypertension | 0.74; (0.6–0.91), P<0.006 | 1.33; (1.27–1.39), P<0.0001 |
| Coronary artery disease | 0.29; (0.07–1.19), P<0.08 | 0.34; (0.31–0.38), P<0.001 |
| Dysthyroidism | 1.8; (1.11–3.22), P<0.01 | 2.69; (2.4–3.02), P<0.0001 |
| Dyslipidemia | 13.36; (6.33–28.18), P<0.000 | 18.24; (15.37–21.63), P<0.0001 |
| Hyperhomocysteinemia | 25.97; (9.66–69.8), P<0.0001 | 11.8; (8.07–17.26), P<0.0001 |
| Smoking | 0.7; (0.04–11.3), P=0.8 | 0.04; (0.01–0.18), P<0.0001 |
CI: Confidence interval, P<0.0001 - Very highly significant, P<0.01 - Highly significant, P<0.05 - Statistically significant
Laterality
Overall, 6,486 (47.46%) patients were affected in the right eye and 6,267 (45.85%) were affected in the left eye. In 914 (6.69%) eyes, the affliction was bilateral.
PVA and FVA
Of the 14581 eyes, the mean PVA was 0.70 log MAR (20/100), indicating moderate visual impairment. At the final follow-up, the mean was 0.50 log MAR (20/60), indicating mild visual impairment. More than one follow-up visit was observed in 6,273 (43.02%) patients. The average number of follow-up visits were 2.69 ± 4.52. The distribution of the eyes with PVA and the FVA is shown in Table 3. The FVA was available for 7,537 eyes, and the remaining patients were lost to follow-up. Among them, 3,181 (21.81%) eyes had stable vision, 3,033 (20.80%) had improvement in vision, and 1,323 (9.07%) had worsening of vision from the initial visit.
| Visual impairment category | Presenting visual acuity (%) | Last visual acuity (%) |
|---|---|---|
| Mild or no visual impairment 0 (<20/70) | 6990 (47.94) | 8081 (55.42) |
| Moderate visual impairment 1 (20/70-20/200) | 3830 (26.27) | 3493 (23.96) |
| Severe visual impairment 2 (20/200-20/400) | 877 (6.01) | 778 (5.34) |
| Blindness 3 (20/400-20/1200) | 1508 (10.34) | 1353 (9.28) |
| Blindness 4 (20/1200-PL) | 91 (0.62) | 130 (0.89) |
| Blindness 5 (NPL) | 43 (0.29) | 73 (0.50) |
| Undetermined or unspecified | 1242 (8.52) | 673 (4.62) |
| Mean Log MAR VA | 0.7±0.7 | 0.5±0.5 |
VA-Visual acuity
Ocular complications associated with BRVO
Among the 14,581 eyes included in the study, associated cataract was documented in 2712 (18.60%) eyes, VH in 805 (5.52%) eyes, glaucoma in 690 (4.73%), diabetic retinopathy in 409 (2.81%) eyes, hypertensive retinopathy in 171 (1.17%) neovascular glaucoma (NVG) in 79 (0.54%) eyes, ocular hypertension in 10 (0.07%), and other retinal disorders in 1874 (12.85%). A detailed overview of ocular complications is mentioned in Figure 2. Hypertensive retinopathy (OR: 1.68; 95% CI: 0.85–3.81) had the highest risk for vision impairment in BRVO. The association between ocular complications and other associated factors with visual impairment is described in Table 4.
- Ocular co-morbidities associated with branch retinal vein occlusion.
| Category | Estimate | Odds ratio | 95% Confidence interval (CI) | P-value | |
|---|---|---|---|---|---|
| Age (diagnosis age) | −0.02 | 0.98 | 0.98 | 0.99 | <0.0001*** |
| Glaucoma (present) | −0.08 | 0.92 | 0.65 | 1.33 | 0.65 |
| Primary open-angle glaucoma (present) | −0.47 | 0.62 | 0.40 | 0.98 | 0.04019* |
| Epiretinal membrane (present) | −0.34 | 0.71 | 0.39 | 1.40 | 0.30 |
| Hypertensive retinopathy (present) | 0.52 | 1.68 | 0.85 | 3.81 | 0.17 |
| Cataract (present) | −0.10 | 0.91 | 0.77 | 1.07 | 0.24 |
| Macular hole (present) | −0.92 | 0.40 | 0.20 | 0.86 | 0.01351* |
| Presenting visual acuity | 0.30 | 1.34 | 1.21 | 1.51 | <0.0001*** |
Treatment
Among 14,581 eyes with BRVO, 5,157 (35.37%) eyes were advised to receive retinal injections for macular edema, out of which 3,741 eyes actually received intravitreal injections. The mean number of injections given in each eye was 2.1 ± 1.79. The mean LogMAR visual acuity for eyes receiving injections improved from 0.7 (20/100) to 0.6 (20/80). Sector laser was performed for 1,652 (11.33%) eyes and macular laser for 380 (2.6%) eyes. Vitrectomy was performed in 533 (3.65%) eyes for VH.
Disease Severity of BRVO between secondary centers and tertiary centers
The mean PVA across secondary and tertiary centers was 0.70 ± 0.70. NVG was reported in 10 (0.47%) eyes in the secondary center and 120 (0.96%) in the tertiary center at the final visit (p<0.0241). An overview of the distribution of disease severity in the secondary and tertiary centers is shown in Table 5.
| Disease severity parameters | Secondary center | Tertiary center | P-value |
|---|---|---|---|
| Presenting visual acuity | 0.70 ± 0.70 | 0.70 ± 0.70 | |
| Patients improved | 129 (6.03%) | 2864 (19.81%) | P<0.00001* |
| ME, VH |
ME-112 (5.24%), VH-63 (2.95%), 175 (8.19%) |
ME-1394 (11.20%), VH-742 (5.96%), 2136 (17.16%) |
P<0.00001* |
| Neovascular glaucoma at final visit | 10 (0.47%) | 120 (0.96%) | P<0.0241 |
ME: Macular edema, VH: Vitreous hemorrhage, *Indicates statistically significant, Chi-Square test was used. Presenting visual acuity is expressed as Mean ± SD (Standard deviation).
DISCUSSION
BRVO is recognized as the second most common retinal vascular disorder after diabetic retinopathy.[20] While the disease has been extensively studied in Western populations, comprehensive analyses focusing on large cohorts from the Asian subcontinent, particularly India, have remained limited. This study aimed to address that gap by evaluating over 13,000 cases, offering a robust understanding of the demographic patterns, systemic associations, clinical presentation, and treatment outcomes of BRVO in a real-world Indian setting.
The overall prevalence of BRVO in our cohort was 0.48%, which closely mirrors the global prevalence of 0.64% among individuals aged 30–89 years, as reported by Rogers et al.[6,21] Our findings reaffirm the well-established age-related increase in BRVO prevalence. Interestingly, unlike some prior studies[6,21], our cohort exhibited a male preponderance and a predominance of unilateral involvement. These findings may reflect regional variations in healthcare access, referral patterns, and possibly systemic disease prevalence within the Indian population.
Consistent with global literature, HTN, DM, and dyslipidemia emerged as the leading systemic risk factors for BRVO in our cohort.[20-23] The growing burden of these non-communicable diseases in India makes their association with retinal vascular occlusions even more clinically significant.[24-26] In addition, hyperhomocysteinemia – known to be more strongly associated with central retinal vein occlusion[27] – was also identified in a subset of BRVO patients in our cohort, including younger individuals under the age of 40. This highlights the need for greater attention to younger patients with BRVO, a population that is often underrepresented in existing literature. Our findings thus underscore the relevance of screening for systemic risk factors, even in younger patients.
Regarding visual function, 47.94% of eyes in our cohort presented with PVA between 20/20 and 20/70. At the final follow-up, 55.42% of eyes achieved a FVA of 20/70 or better. These results are consistent with previous reports, such as Rehak and Rehak et al.[5], who noted that 50–60% of BRVO eyes maintained or improved to an FVA of better than 20/40. The incidence of BRVO in both eyes was 6.69% in our study, which is in line with published bilateral BRVO rates of 7–10%.[1,6]
A crucial clarification is necessary regarding the classification of associated conditions. In the initial analysis, VH and NVG were noted as comorbidities. However, these are known complications of BRVO rather than pre-existing conditions. Hence, we have reclassified them accordingly. The prevalence of NVG in our study was 0.45%, which is lower than the 2.2% reported in the SCORE-BRVO study.[23] In fact, Hayreh et al.[20,28] reported no NVG cases in their BRVO cohort, highlighting the variability of its incidence. Our lower rates may reflect earlier detection, spontaneous resolution in many cases, or variations in follow-up duration.
The treatment approaches in our cohort also revealed some insightful trends. Notably, 63.30% of patients did not require any treatment, reflecting the self-limiting nature of BRVO in many cases, particularly those without significant macular edema or ischemia. When required, intravitreal therapy – either anti-VEGF or corticosteroids – was the most commonly used intervention. The mean number of injections per eye was two, which is significantly lower than the five or more injections recommended in studies such as LUMINOUS[29] and BRAVO.[30] This under-treatment likely contributed to the modest visual acuity improvement (2-line gain on average) observed in our cohort, compared to the 3–5 line gains typically reported in clinical trials.[29-32] Such discrepancies highlight the gap between controlled clinical trials and real-world practices, where patient follow-up, financial constraints, and systemic health may limit aggressive therapy. Similar under-treatment trends in retinal vein occlusion have been previously reported.[33]
Despite the scale of this study, certain limitations should be acknowledged. The hospital-based, retrospective nature of the dataset introduces the possibility of selection bias, as patients presenting to tertiary eye care centers may not reflect the broader population. In addition, the lack of long-term follow-up in many cases limits our ability to assess disease progression, recurrence, or delayed complications such as neovascular glaucoma (NVG). Furthermore, not all risk factors – such as thrombophilic disorders or inflammatory conditions – could be comprehensively evaluated due to inconsistent systemic workups.
Nonetheless, this study offers several strengths. To the best of our knowledge, it is the largest BRVO cohort analyzed in India, utilizing a structured EMR system to ensure consistency in data capture. Importantly, this is also one of the few studies to report BRVO prevalence, systemic associations, visual outcomes, and treatment patterns across a broad age spectrum – including younger patients – and across urban, rural, and metropolitan populations in the Indian subcontinent.
CONCLUSION
Although the results of our study may not represent novel findings globally, they provide valuable real-world evidence from a large and diverse population, helping to bridge the gap between controlled trials and routine clinical practice in India. Most cases of BRVO are unilateral and self-limiting, with systemic vascular diseases being key associated factors. Intravitreal therapy remains effective but appears to be underutilized in real-world Indian settings. These insights may aid in the development of region-specific guidelines for BRVO management and enhance awareness among general physicians and ophthalmologists regarding the importance of systemic disease control in patients presenting with retinal vascular occlusions.
Acknowledgment:
The authors wish to acknowledge the support of the Department of eyeSmart EMR and AEye team, especially Mr. Ranganath Vadapalli and Mr. Mohammad Pasha. Financial support and sponsorship: Hyderabad Eye Research Foundation, Department of Biotechnology Wellcome Trust India Alliance Clinical Research Center Grant was awarded to Indian Health Outcomes, Public Health and Economics Research Centre (grant number IA/CRC/19/1/610010).
Ethical approval:
The research/study was approved by the Institutional Review Board at LV Prasad Eye Institute, Hyderabad, India, number LEC-BHR-R-08-21-740, dated LECBHR-R-08-21-740.
Declaration of patient consent:
The authors certify that they have obtained all appropriate patient consent.
Conflicts of interest:
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation:
The authors confirm that there was no use of artificial intelligence (AI)-Assisted Technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
Financial support and sponsorship: DBT Wellcome Trust India Alliance, Clinical Research Centre IA/CRC/19/1/610010.
References
- Branch retinal vein occlusion: Epidemiology, pathogenesis, risk factors, clinical features, diagnosis, and complications, An update of the literature. Retina. 2013;33:901-10.
- [CrossRef] [PubMed] [Google Scholar]
- Arteriovenous crossing patterns in branch retinal vein occlusion. The Eye Disease Case-Control Study Group. Ophthalmology. 1993;100:423-8.
- [CrossRef] [PubMed] [Google Scholar]
- The epidemiology of retinal vein occlusion: The Beaver Dam eye study. Trans Am Ophthalmol Soc. 2000;98:133-41. discussion 141-3
- [Google Scholar]
- Macular grid laser photocoagulation for branch retinal vein occlusion. Cochrane Database Syst Rev. 2015;2015:CD008732.
- [CrossRef] [PubMed] [Google Scholar]
- Branch retinal vein occlusion: Pathogenesis, visual prognosis, and treatment modalities. Curr Eye Res. 2008;33:111-31.
- [CrossRef] [PubMed] [Google Scholar]
- The prevalence of retinal vein occlusion: Pooled data from population studies from the United States, Europe, Asia, and Australia. Ophthalmology. 2010;117:313-9.e1.
- [CrossRef] [PubMed] [Google Scholar]
- Branch retinal vein occlusion In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535370 [Last accessed on 2024 Jun 11]
- [Google Scholar]
- Characteristics of major and macular branch retinal vein occlusion. Sci Rep. 2022;12:14103.
- [CrossRef] [PubMed] [Google Scholar]
- Prevalence and associations of retinal vein occlusions: The Central India Eye and Medical Study. Retina. 2013;33:152-9.
- [CrossRef] [PubMed] [Google Scholar]
- Young patients with branch retinal vein occlusion: A review of 60 cases. Retina. 2010;30:1520-3.
- [CrossRef] [PubMed] [Google Scholar]
- Integrated model of primary and secondary eye care for underserved rural areas: The L V Prasad Eye Institute experience. Indian J Ophthalmol. 2012;60:396-400.
- [CrossRef] [PubMed] [Google Scholar]
- Incidence, demographics, types and risk factors of dry eye disease in India: Electronic medical records driven big data analytics report I. Ocul Surf. 2019;17:250-6.
- [CrossRef] [PubMed] [Google Scholar]
- Diabetes UK. 2017. Available from: https://www.diabetes.org.uk/for-professionals/improving-care/clinical-recommendations-for-professionals/diagnosis-ongoing-management-monitoring/new_diagnostic_criteria_for_diabetes [Last accessed on 2025 Jan 02]
- [Google Scholar]
- Hypertension diagnosis, treatment, and control in India. JAMA Netw Open. 2023;6:e2339098.
- [CrossRef] [PubMed] [Google Scholar]
- Dyslipidemia In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2024.
- [PubMed] [Google Scholar]
- Homocystinuria diagnosis and management: It is not all classical. J Clin Pathol. 2022;75:744-50.
- [CrossRef] [PubMed] [Google Scholar]
- An update on advances in COVID-19 laboratory diagnosis and testing guidelines in India. Front Public Health. 2021;9:568603.
- [CrossRef] [PubMed] [Google Scholar]
- Developing a model to reduce blindness in India: The International Centre for Advancement of Rural Eye Care. Indian J Ophthalmol. 1998;46:263-8.
- [Google Scholar]
- Available from: https://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-impairment [Last accessed on 2024 Dec 30]
- Risk factors for central and branch retinal vein occlusion: A meta-analysis of published clinical data. J Ophthalmol. 2014;2014:724780.
- [CrossRef] [PubMed] [Google Scholar]
- Global epidemiology of retinal vein occlusion: A systematic review and meta-analysis of prevalence, incidence, and risk factors. J Glob Health. 2019;9:10427.
- [CrossRef] [PubMed] [Google Scholar]
- Ten-year incidence and assessment of safe screening intervals for diabetic retinopathy: The OPHDIAT study. Br J Ophthalmol 2021:105432-9.
- [CrossRef] [PubMed] [Google Scholar]
- Risk factors of branch retinal vein occlusion (BRVO) a study at tertiary care centre. Indian J Clin Exp Ophthal. 2018;4:193-6.
- [CrossRef] [Google Scholar]
- Retinal vein occlusion and traditional risk factors for atherosclerosis. Arch Ophthalmol. 2008;126:692-9.
- [CrossRef] [PubMed] [Google Scholar]
- Epidemiology of type 2 diabetes in India. Indian J Ophthalmol. 2021;69:2932-8.
- [CrossRef] [PubMed] [Google Scholar]
- Hypertension control rate in India: Systematic review and meta-analysis of population-level non-interventional studies, 2001-2022. Lancet Reg Health Southeast Asia. 2023;9:100113.
- [CrossRef] [PubMed] [Google Scholar]
- Hyperhomocysteinemia, as an independent risk factor for retinal venous occlusion in an Indian population. Indian J Clin Biochem. 2013;28:61-4.
- [CrossRef] [PubMed] [Google Scholar]
- Ocular neovascularization with retinal vascular occlusion-III, Incidence of ocular neovascularization with retinal vein occlusion. Ophthalmology. 1983;90:488-506.
- [CrossRef] [PubMed] [Google Scholar]
- Real-world outcomes with ranibizumab in branch retinal vein occlusion: The prospective, global, LUMINOUS study. PLoS One. 2020;15:e0234739.
- [CrossRef] [PubMed] [Google Scholar]
- Branch retinal vein occlusion: Natural history of visual outcome. JAMA Ophthalmol. 2014;132:13-22.
- [CrossRef] [PubMed] [Google Scholar]
- Ocular vascular occlusive disorders: Natural history of visual outcome. Prog Retin Eye Res. 2014;41:1-25.
- [CrossRef] [PubMed] [Google Scholar]
- Three Monthly injections versus one initial injection of ranibizumab for the treatment of macular edema secondary to branch retinal vein occlusion: 12-Month results of a prospective randomized study. Ophthalmol Ther. 2022;11:2309-20.
- [CrossRef] [PubMed] [Google Scholar]
- Sub-optimal gain in vision in retinal vein occlusion due to under-treatment in the real world: Results from an open-label prospective study of Intravitreal Ranibizumab. BMC Ophthalmol. 2021;21:33.
- [CrossRef] [PubMed] [Google Scholar]