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This study demonstrates the significant association between the Charlson Comorbidity Index (CCI) and 1-year visual outcomes in patients with macular edema secondary to retinal vein occlusion (RVO). Higher CCI scores predicted poorer visual acuity outcomes, especially in patients with a high comorbidity burden. Baseline visual acuity remained a strong predictor of final visual results across all comorbidity levels. Notably, CCI’s impact on central subfield thickness (CST) was significant only in patients with lower comorbidity scores.