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To investigate the natural history of visual outcome in hemicentral retinal vein occlusion (HCRVO).The study comprised 65 consecutive HCRVO patients (67 eyes) seen within 3 months of onset. At first visit, all patients had a detailed ophthalmic and medical history and comprehensive ophthalmic evaluation. Ophthalmic evaluation at initial and follow-up visits included recording visual acuity using the Snellen visual acuity chart, and visual fields with a Goldmann perimeter. Hemicentral retinal vein occlusion was classified into nonischemic (57 eyes) and ischemic (10 eyes) at initial visit.Nonischemic HCRVO involved superior and inferior half of the retina in 39% and 56%, respectively, and in ischemic HCRVO in 50% and 40%, respectively. In nonischemic HCRVO, initial visual acuity was 20/60 or better in 73.7% and minimal to mild visual field loss in 96% and in ischemic HCRVO in 40% and 55.5%, respectively. After resolution of macular edema, in nonischemic HCRVO eyes, cumulative chance of improvement was 50% with 20/70 or worse initial visual acuity, and deterioration in only 6% with 20/60 or better initial visual acuity, and in 5% with minimal to mild visual initial field loss.This study suggests a good prognosis in the natural history of visual outcome in nonischemic HCRVO.