Objective lt;brgt;To inspect the rate of success of anastomosis and tissue damage with different power levels of photocoagulation in the treatment of experimental branch retinal vein occlusion (BRVO) by laser induced chorioretinal venous anastomosis. lt;brgt;Methods lt;brgt;Forty pigmented rabbits (80 eyes) were divided into four groups in random, and 10 (20 eyes) in each. Chroioretinal venous anastomosis was attempted to create using the krypton red laser with 4 different power levels (group A: 400 mW,group B: 600 mW,group C: 800 mW,group D: 1000 mW) in these animals in which BRVO had previously been created photodynamically. Fundus photography and fundus fluorescein angiography were performed at various times after the treatment and histological examination was taken at the end of the study. lt;brgt;Results lt;brgt;The model of BRVO was successfully set up. At the lowest power of 400 mW there was an absence of anastomosis formation and the damage to the retina and choroid was mild, Bruch′s membrane showed no evidence of rupture. At the power levels of 600 mW and 800 mW an anastomosis formed in 15% and 55% respectively and the damage was medium in degree. At the highest power level of 1 000 mW a 80% rate of success was obtained, however, the damage to the retina and choroid tended to be severe.The difference of the rate of success of anastomosis between different groups was highly significant (P=0.001), the difference between group B and group C was also highly significant (PBC=0.008), and the difference between group A and group B, group C and group D was not significant (PAB=0.072、PCD=0.091). lt;brgt; lt;brgt;Conclusion lt;brgt;The optimal power level of krypton red laser induced chorioretinal venous anastomosis is 800 mW, 0.1 s, 50 μm in our study. lt;brgt; lt;brgt;(Chin J Ocul Fundus Dis,2002,18:13-16)
Objective To evaluate the correlation between antiphospholipid (APLA) antibodies and retinal vein occlusion (RVO). Methods A computerized search was conducted in the Pubmed, Chinese Biological Medicine Database, China National Knowledge Infrastructure, VIP database, Wanfang Database combined with manually searching of literature reference proceedings. The search time was ranged from establishment of each database to August 1st, 2012. After the data extraction, quality of RCT was assessed. The meta analysis was performed by Stata 11.0. Results In total, 12 case-control studies (1324 subjects) that fulfilled the eligibility criteria were included in the meta-analysis involving 505 patients in RVO group and 819 subjects in control group. The odds ratio (OR) and 95% confidence interval (CI) of APLA, anticardiolipin antibodies (ACA), lupus coagulation inhibitor and RVO were 5.01 and 3.33 - 7.53,4.38 and 2.38 - 8.05, 1.72 and 0.73 - .88, 6.02 and 2.06 - 17.63, respectively. The OR and 95% CI of APLA, ACA, lupus coagulation inhibitor and branch RVO were 4.22 and 1.67 - 10.63, 3.69 and 1.32 - 10.32, 2.07 and 0.79 - 5.41, respectively. Conclusions APLA may increase the rick of RVO, especially ACA has a prediction function to RVO. It is necessary to screening for APLA in RVO patients.
PURPOSE:To investigate the content of vascular endothelial growth factor (VEGF)in vitreous of patients with retinal vascula'r proliferative diseases. METHODS:The concentration of VEGF in undiluted vitreous samples from patients with retina vein occlusion (RVO) (n=7),Eales disease (n=7)and controls (n=7) was measured by enzyme linked immunosorbent assay (EL1SA). RESULTS:The levels of vitreous VEGF were significantly higher 13 folds in patients with RVO(4.67plusmn;3.38)ng/ml and 5 folds in patients with Eales disease(1.79plusmn;0.44)ng/ml than in controls (0.35plusmn;0.15)ng/ml separately(P＜0. 01). CONCLUSIONS:VEGF might play a part in mediating the neovascularization of retinal vascular diseases. （Chin J Ocul Fundus Dis,1997,13:171-173）
Objective To investigate the changes of ocular hemodynamics in patients with retinal vein occlussion(RVO)． Methods The hemodynamic parameters(PSV,EDV,PI,Vmax)of central retinal artery(CRA)and central retinal vein(CRV)were measured in the involved eyes(n=48) with RVO and the contralateral clinically healthy eyes(n=39) and in the control eyes(n=40) by color Doppler imaging (CDI)(ATLHDI3000). Results Peak systolic velocity (PSV) and end diastolic velocity (EDV) were significantly lower in the CRA of involved eyes and clinically healthy eyes of patients with RVO compared with control eyes,and pulsatility index(PI)was significantly higher in the CRA of involved eyes of patients with RVO compared with control eyes．PSV were significantly lower in the CRA of involved eyes of patients with RVO compared with their clinically healthy eyes．Pulsatility index(PI)was significantly higher in the CRA of involved eyes of patients with RVO compared with their clinically healthy eyes．Maximun vein velocity (Vmax) was significantly lower in the CRV of involved eyes and clinically healthy eyes of patients with RVO compared with control eyes． Conclusion The changes of hemodynamics in CRA,CRV of involved eyes of patients with RVO may invade their clinically healthy eyes．CDI may be helpful to early diagnosis for RVO． (Chin J Ocul Fundus Dis,1998,14:111-113)
ObjectiveTo observe the clinical features of collateral circulation in different types of retinal vein occlusion. MethodsA retrospective clinical study. A total of 360 patients with monocular retinal vein occlusion diagnosed by ophthalmic examination in Department of Ophthalmology of Yunnan University Affiliated Hospital from December 2021 to December 2023 were included in the study. Among them, 157 males had 157 eyes and 203 females had 203 eyes. Age were (61.0±5.9) years. The duration of the disease from the onset of symptoms to the time of treatment was 3 days to 6 months. Macular branch vein occlusion (MBRVO), retinal branch vein occlusion (BRVO) and central retinal vein occlusion (CRVO) were observed in 67, 187 and 106 eyes, respectively. 210 eyes were with macular edema. All patients with macular edema were treated with anti-vascular endothelial growth factor (VEGF) by intravitreal injection. All eyes were examined by scanning source optical coherence tomography. The incidence, location, morphological characteristics, formation time of retinal collateral circulation and the effect of anti-VEGF drug on the formation of collateral circulation were observed. A short circuit in which blood vessels originating from the optic disc in the form of a blood loop return to the optic disc after the disc has been deformed for some time is defined as a short-circuited collateral circulation of the ciliary vessels of the optic disc. ResultsAfter 1 week of disease course, MBRVO and collateral circulation of BRVO affected eye were established. By 1 to 2 months, a relatively abundant and stable collateral circulation had been established. In the course of 2 to 3 months, the short-circuit collateral circulation of ciliary vessels in the optic disc of the affected eye gradually formed. At 6 months, collateral circulation was established in 36 eyes (53.7%, 36/67) in 67 MBRVO patients. Collateral circulation was observed in 187 eyes of BRVO patients (100.0%, 187/187). In 106 eyes with CRVO, collateral circulation was established in 29 eyes (18.1%, 29/106). In 36 eyes with MBRVO, collateral circulation was established at the vertical horizontal slit between the blocked area and the non-blocked area. In 187 eyes of BRVO patients, collateral circulation was established in the vertical horizontal slit between the blocked and non-blocked areas in 102 eyes; 54 eyes were blocked the most central bypass to the collateral circulation on normal blood vessels. The collateral circulation of 19 eyes was established through nasal and temporal side. Collateral circulation through the fovea was established in 12 eyes. Its morphology is straight out of shape, spiral sinuous and flower cluster. CRVO established collateral circulation in 29 eyes, all of which had short-circuit collateral circulation of ciliary vessels. In 210 eyes treated with anti-VEGF drugs, collateral circulation was established in 160 eyes. Among them, 32 eyes were MBRVO (50.7%, 32/63), BRVO 119 eyes (100.0%, 119/119), CRVO 9 eyes (32.1%, 9/28). ConclusionsThe incidence of collateral circulation of MBRVO, BRVO and CRVO is 53.7%, 100.0% and 18.1%, respectively. The forms of MBRVO were varied and the course of disease is about 2 months. Anti-VEGF therapy did not inhibit the establishment of collateral circulation.
Retinal vein occlusion (RVO) is a vascular disease characterized by intraretinal hemorrhage, edema and hard exudation, which is caused by increased retinal vein pressure. OCT angiography (OCTA) has been widely used in the diagnosis of retinal vascular diseases including RVO by virtue of non-invasive, high resolution and stratified display of superficial, deep retinal vessels and quantification of retinal vessel density and non-perfusion area size. OCTA can provide information of retinal microvascular structure and blood perfusion under the condition of disease, it also can be used to evaluate the effect of treatment and changes of retinal circulation during the course of disease follow-up. Although OCTA cannot replace fundus angiography completely, it has brought us more information about the pathogenesis, disease progression and prognostic factors of RVO. It is believed that with the progress of technology, OCTA will bring us a new chapter in the study of retinal vascular diseases including RVO.
Retinal vein occlusion (RVO) is one of the most common retinal vascular diseases causing blindness, macular edema (ME) is often secondary to it, which causes serious visual impairment to patients. Imaging biomarkers in the changes of retina and choroid of ME secondary to RVO (RVO-ME) have important clinical value in the evaluation of condition, curative effect and visual acuity prediction of patients with RVO-ME. Among them, the disorganization of the retinal inner layers, the integrity of external limiting membrane and ellipsoid zone, and the change of central macular thickness are reliable indexes to evaluate the prognosis of visual acuity; hyperreflective foci, subretinal fluid and intraretinal fluid can be used as important parameters to reflect the level of inflammation; prominent middle limiting membrane and paracentral acute middle maculopathy are the objective basis for judging the degree of retinal ischemia; the changes of choroidal vascular index and choroidal thickness also have potential advantages in evaluating the progress of the disease. Accurately grasp the characteristics of biological markers of RVO-ME related optical coherence tomography is conducive to its reasonable and accurate use in the clinical diagnosis and treatment of RVO-ME, and helpful to further explore the pathogenesis of the disease.
Objective To analyze the risk factors of postoperative vitreous hemorrhage (PVH) after pars plana vitrectomy (PPV) for vitreous hemorrhage (VH) secondary to retinal vein occlusion (RVO). Methods A retrospective case-control study. A total of 195 RVO patients (195 eyes) with VH were first treated with PPV from November 2015 to December 2021 were included in this study. There were 102 males (102 eyes) and 93 females (93 eyes), with an age of (62.93±9.78) years. The patients were divided into PVH group (17 patients, 8.72%) and non-PVH group (178 patients, 91.28%) according to the occurrence of PVH. The time of occurrence of PVH was (140.33±130.85) days after PPV. All eyes were performed 23G or 25G systematic PPV by the same doctor. During the operation, different types of intraocular tamponade and intravitreal injection of anti-vascular endothelial growth factor or triamcinolone acetonide after operation were selected according to the severity of retinopathy. The follow-up time was (9.45±6.68) months. The baseline systemic parameters, ocular parameters and intraoperative parameters affecting the occurrence of PVH were analyzed. Baseline systemic parameters included sex, age, diabetes mellitus and hypertension; ocular parameters included RVO type, lens status, VH course, preoperative best corrected visual acuity and intraocular pressure; intraoperative parameters included cataract phacoemulsification, removal of internal limiting membrane, type of intraocular tamponade, type of intravitreal injection drug at the end of operation, etc. Kaplan-Meier survival analysis, and Cox univariate and multivariate regression analysis were performed to analyze the risk factors of PVH after PPV in RVO with VH patients. Results In PVH group, the number of patients with diabetes was more than that in the non-PVH group, and the course of diabetes was longer, and differences were statistically significant. There were significant differences in RVO type, lens status and type of intraocular tamponade. Univariate Cox regression analysis showed that the combination with diabetes [odds ratio (OR)=2.724, 95% confidence interval (CI) 1.006-7.374, P=0.049], duration of diabetes (OR=1.071, 95%CI 1.013-1.134, P=0.016), central retinal vein occlusion (OR=4.387, 95%CI 1.421-13.546, P=0.010), intraocular lens (OR=3.493, 95%CI 1.229-9.925, P=0.019), and intraocular gas tamponade (OR=3.640, 95%CI 1.365-9.702, P=0.010) were associated with PVH. Multivariate Cox regression analysis showed that intraocular gas tamponade was independent risk factor for PVH. Conclusion Intraocular gas tamponade can increase the risk of PVH after PPV in patients with VH secondary to RVO.
Objective lt;brgt;To evaluate the efficacy of arteriovenous sheathotomy on treatment of branch retinal vein occlusion (BRVO). lt;brgt; lt;brgt;Methods lt;brgt;Six consecutive patients (6 eyes) with BRVO underwent par plana vitrectomy, po lt;brgt;sterios vitreous cortex separation, arteriovenous sheathotomy for BRVO. The foll lt;brgt;owup period was within 3～12 months. Postoperative examinations included color fundus photography, fundus fluorescein angiography(FFA), optical coherence tomography(OCT) and multifocal electroretinography (mERG). lt;brgt; lt;brgt;Results lt;brgt;Increasing downstream blood flow in proximal past of compressed venule was promptly observed during the procedures of incision of the advential sheath of blood vessel, and separating and elevating the ateriole from the venule in all the operations in this series. Visual acuities improved postoperatively in 5 patients, and the best corrected visual acuity was 1.5. The examination of FFA showed obvious absorption of retinal hemorrhage, and leakage of dye was reduced, while large areas of capillary closure in retinas distal to the sheathotomy site were found 3 months after operation in 3 patients. OCT revealed disappearance or lightening of macular edema. mERG showed that the response amplitude of retina including the macular area was obviously higher after the operation. There was recurrent vitreous hemorrhage necessitating further surgery in one patient. lt;brgt; lt;brgt;Conclusion lt;brgt;The operation of arteriovenous sheathotomy for the treatment of BRVO is much beneficial to improve patient′s visual acuity, downstream blood flow and macular affections, although the improvement of retinal reperfusion of the retina is not obvious. lt;brgt; lt;brgt;(Chin J Ocul Fundus Dis,2002,18:6-9)
ObjectiveTo observe the short-term efficacy of posterior sub-tenon injection of triamcinolone acetonide (PSTA) in the treatment of macular edema due to ischemic retinal vein occlusions (RVO). MethodsA retrospective clinical study. A total of 53 eyes of 53 patients with RVO macular edema diagnosed by fundus color photography, fundus fluorescein angiography and optical coherence tomography (OCT) were included in the study. The best corrected visual acuity (BCVA) was detected by the international standard visual acuity chart, and the results were converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity. The central macular thickness (CMT) was measured by OCT. Among 53 eyes, there were 27 eyes with ischemic RVO macular edema (ischemic group) and 26 eyes with non-ischemic RVO macular edema (non-ischemic group). The mean logMAR BCVA was 0.82±0.37, mean CMT was (662.1±216.7) μm in ischemic group. The mean logMAR BCVA was 0.41±0.23, mean CMT was (548.0±161.9) μm. The differences of logMAR BCVA and CMT between the two groups were both statistically significant (t=4.745, 2.258; P<0.05). All eyes were treated with a single sub-Tenon injection of 0.4 ml triamcinolone acetonide suspension (100 mg/ml).The mean logMAR BCVA, CMT before and 1, 3 months after the treatment between the two groups were observed and compared. ResultsOn 1 and 3 months after treatment, the mean logMAR BCVA in the non-ischemic group (0.32±0.25 and 0.27±0.29) were improved compared with ischemic group (0.76±0.37 and 0.41±0.79), the difference was statistically significant (t=5.052, 5.240; P<0.05). The mean logMAR BCVA before and after treatment had no statistically significant difference in ischemic group (F=0.516, P>0.05), but had a statistically significant difference in non-ischemic group (F=7.685, P<0.05). On 1 and 3 months after treatment, the mean CMT in the ischemic group were (534.7±223.4), (470.8±234.7) μm, which were lower (127.4±28.28), (191.4±34.55) μm before treatment. In the non-ischemic group, the average CMT was (426.2±188.8), (371.3±200.6) μm, which were lower (103.1±33.1), (164.9±49.6) μm. There were statistically significant differences in the mean CMT between the ischemic group and the non-ischemic group (F=17.040, 10.360; P<0.05). In non-ischemic group, CMT had a bigger reduction compared to the the ischemic group (t=2.056, 2.103; P<0.05). The difference of CMT decrease value between two groups was not statistically significant (t=0.560, 0.441; P>0.05). On 1 month after the treatment, there were 3 and 5 eyes had a higher intraocular pressure than 21 mmHg (1 mmHg=0.133 kPa) in ischemic and non-ischemic group, respectively; but all of them returned to normal after drug treatment. There were no drugs and ocular injection related complications. ConclusionPSTA of ischemic RVO macular edema can lower the CMT in the short term, but can't significant improve the visual acuity.