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AIM: To analyze the efficacy and safety of safflor yellow injection combined with anti-vascular endothelial growth factor(VEGF)drug in the treatment of non-ischemic central retinal vein occlusion(CRVO).METHODS: A total of 91 patients(91 eyes)with non-ischemic CRVO complicated with macular edema who were treated in the Affiliated Eye Hospital of Nanchang University from April 2017 to December 2021 were selected. They were randomly divided into observation group, with 47 cases(47 eyes)treated with safflor yellow injection combined with intravitreal injections of ranibizumab, and control group with 44 cases(44 eyes)who were treated with intravitreal injections of ranibizumab. Followed-up for 11mo, the best corrected visual acuity(BCVA)and macular central retinal thickness(CRT)of the two groups were observed and the cases of complete absorption of retinal hemorrhage, the times of anti-VEGF drug injections, the cases of ischemic CRVO, and the occurrence of systemic or ocular complications were recorded.RESULTS: At 1, 2, 3, 5, 7, 9 and 11mo after treatment, the BCVA and CRT in both groups were significantly improved compared with those before treatment, and BCVA and CRT in the observation group were superior to the control group at 3, 5, 7, 9 and 11mo after treatment(all P<0.05). At 5, 7, 9 and 11mo after treatment, the complete absorption rate of retinal hemorrhage in the observation group was higher than that in the control group(P<0.05). During the follow-up period, the anti-VEGF drug injection in the observation group was significantly less than that in the control group(4.83±1.05 vs. 5.75±1.01, P<0.05), and the incidence of ischemic CRVO was significantly lower than that in the control group(21% vs. 86%, P<0.05), and there were no treatment-related systemic and ocular complications in both groups.CONCLUSION: Safflor yellow injection combined with anti-VEGF drugs is a safe and effective method for the treatment of non-ischemic CRVO, which can significantly improve vision and reduce CRT. It can increase the complete absorption rate of retinal hemorrhage, reduce the times of anti-VEGF drug injections and the incidence of ischemic CRVO compared with monotherapy of anti-VEGF drug.
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Objective:To observe the imaging features of fundus lesions associated with COVID-19.Methods:A observational case series study. Twenty eyes of 10 patients with fundus lesions associated with COVID-19 at Xiamen Eye Center of Xiamen University from December 10, 2022 to January 20, 2023 were included in this study. There were 1 males and 9 females, aged from 17 to 49 years, with the median age of 26 years. The time of ocular symptoms after the diagnosis of COVID-19 was 0-2 days. The time from the onset of ocular symptoms to seeing a doctor was 1-14 days. All patients were examined by best-corrected visual acuity (BCVA), intraocular pressure, color fundus photography, infra-red fundus photography (IR), optical coherence tomography (OCT). Serum D-dimer examination was performed in 3 patients. The median BCVA was 0.4. There was no abnormalities in intraocular pressure and anterior segment examination. Among 20 eyes of 10 patients, there were 10 eyes of 5 patients with acute macular neuroretinopathy (AMN), 6 eyes of 3 patients with Purtscher-like retinopathy (PLR), 4 eyes of 2 patients with central retinal vein occlusion (CRVO). The imaging features of fundus were observed and analyzed.Results:Retinal lesions included AMN, paramacular central medial retinopathy (PAMM), PLR, cotton wool spots, hemorrhage, optic disc edema, macular edema. AMN was found in 10 eyes, with reddish-brown and wedge-shaped lesion in the fovea, dark area in IR and hyper reflectivity in outer nuclear layer and outer plexiform layer by OCT. The cotton wool spot showed hyper reflectivity on retinal nerve fiber layer whereas PAMM showed band-shape hyper reflectivity in inner nuclear layer by OCT. The Purtscher spot was seen at the posterior pole and/or peripapillary in 6 eyes of PLR. By OCT examination, the retinal nerve fiber layer corresponding to Purtscher flecken was significantly thickened and the reflex was enhanced. Among 6 eyes of PLR, there were 4 eyes combined with AMN, 1 eye with PAMM and macular edema. In 4 eyes of CRVO, vitreous cells, optic disc edema, retinal flame, spot hemorrhage, and atypical cotton wool spots were seen in 2 eyes.Conclusions:The manifestations of fundus lesions associated with COVID-19 are varied. The multilayer structure of retina is involved, and the microvessels of retina and choroidal capillary layer are damaged.
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Mucormycosis is a serious, rapidly progressing, life-threatening, and sight threatening fungal infection frequently seen in diabetics and immunocompromised patients. We report a rare occurrence of rhino-orbital mucormycosis presenting as unilateral central retinal vein occlusion (CRVO) and no other ocular signs of infection in a 65-year-old diabetic male. The definitive diagnosis was made by nasal biopsy which confirmed broad branching aseptate fungal hyphae. The patient was treated with amphotericin B for mucormycosis and intravitreal anti-vascular growth factor (anti-VEGF) drug for macular edema. To conclude, although ophthalmoplegia is the most common ocular presentation and retinal artery occlusion is the most common cause of visual loss in mucormycosis, it may have many varied presentations including CRVO. A high index of suspicion must be kept in diabetics and immunocompromised patients
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We present a case of Ischemic Central retinal vein occlusion (CRVO) caused by hypertension secondary to renal failure in IgA nephropathy. A 17 year old male came with chief complaints of sudden painless diminution of vision in RE since 15 days. On examination the Right eye showed multiple superficial retinal haemorrhages in all 4 quadrents with dilated veins and cystoid macular edema suggestive of CRVO and Left eye showed superficial flame shaped haemorrhage suggestive of grade 3 hypertensive changes.
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The coagulation abnormalities and thromboembolic complications of coronavirus 2 (SARS-CoV-2) are now a well-established fact. The hypercoagulable state, the tendency for thromboembolism, and a cytokine surge state have been the exclusive reasons for multiorgan failure and other morbidities that have been regularly reported in COVID-19 patients. Ocular involvement in patients with active disease and those who have recovered is uncommon but not rare. We report a case series of four patients with CRVO, BRVO, CRAO, and vitreous hemorrhage in patients with proven COVID-19 infection and no other systemic ailments. The case series also tries to correlate the elevated D-dimer values, which signify a plausible prothrombotic state with the vaso-occlusive phenomenon in the retina leading to significant visual morbidity.
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Purpose: To investigate the rate of secondary glaucoma after intravitreal (IV) dexamethasone implant (ozurdex) 0.7 mg injection in a retinal disorder over a clinical treatment period of 2 years in a tertiary eye care center. Methods: Retrospective study based on the records of patients receiving IV ozurdex 0.7 mg implant for T/t of cystoid macular edema (CME), diabetic macular edema (DME), macular edema due to central retinal vein occlusion/branch retinal vein occlusion (CRVO/BRVO), and choroidal neovascular membrane (CNVM) at a tertiary eye care hospital for 2 years with 6 months of follow?up. The post?T/t intraocular pressure (IOP) and antiglaucoma medication (AGM) required was recorded at day 1, 1 week, 1, 2, 3, 4, and 6 months and analyzed for secondary IOP spike or ocular hypertension defined as IOP >21 mmHg at any point in time. The patients with pre?existing glaucoma and lost to follow?up were excluded. Results: A total of 102 eyes of 80 patients were included in the study. The mean baseline IOP was 14.40 + 2.97 mmHg, post?injection was 15.01 + 3.22 mmHg at day 1, 15.15 + 3.28 mmHg at 1 week, 15.96 + 3.62 mmHg at 1 month, 16.26 + 3.95 mmHg at 2 months, 15.41 + 3.33 mmHg at 3 months, 15.38 + 3.28 mmHg at 4 months, and 14.27 + 2.69 mmHg at 6 months. No significant difference was seen from baseline IOP at day 1 (P = 0.163), 1 week (P = 0.086), and 6 months (P = 0.748). Statistically significant difference was seen at 1 month (P = 0.0009), 2 months (P = 0.0001), 3 months (P = 0.023), and 4 months (P = 0.026). The mean IOP peak at 2 months recovered to baseline by 6 months subgroup IOP trend shows a similar variation and the results are consistent with the studies in the literature. About 19/102 (18.62%) eyes showed an IOP spike post?T/t. The maximum was seen at 2 months; 16 eyes showed a rise in the range 22–25 mmHg; 8 in the range 26–30 mmHg; and 1 eye had 34 mmHg and required multiple AGM—no surgical intervention was needed. Conclusion: A secondary IOP spike post?IV ozurdex 0.7 mg seen in 18.62% of the cases require AGM. The IOP monitoring should be meticulously performed for the variations and secondary IOP spike management to prevent irreversible damage to the optic nerve and visual field
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Central retinal vein occlusion(CRVO)is a common retinal vascular disease that severely affects visual acuity. Currently, ranibizumab, aflibercept and dexamethasone implant have been successful in treating macular edema associated with CRVO. However, there were still 1/3 patients with no significant improvement in vision after treatment, 30.7% patients with macular edema subsiding after treatment but recurring, and 28.1% patients with macular edema persisting after treatment. How to determine the prognosis of patients by their different clinical manifestations at the early stage of disease onset can help clinicians to better select treatment options for patients according to their specific disease conditions. Recent studies on the prognosis of CRVO treatment have focused on imaging markers including disorganization of retinal inner layers, retinal hyperreflective foci, subretinal fluid, ischemic index, leakage index, and biomarkers including VEGF, interleukin(IL)-6, IL-8, etc. This article reviews the progress of research on factors related to the prognosis of CRVO, with the aim of treating, managing and monitoring patients with CRVO more precisely and effectively.
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Objective:To explore the microvasculature changes in macular area of central retinal vein occlusion (CRVO) patients with macular edema (ME).Methods:A cross-sectional study was conducted.Fifteen patients with monocular ME secondary to CRVO (30 eyes) and 15 age- and gender-matched normal subjects (15 eyes) were enrolled in The Second Affiliated Hospital of Chongqing Medical University from November 2017 to March 2019.Best corrected visual acuity (BCVA), intraocular pressure, slit lamp microscope with pre-set lens, color fundus photography and optical coherence tomography (OCT) were performed in all subjects.The central macular thickness (CMT), foveal avascular zone (FAZ) area, FAZ perimeter, acircularity index (AI), vessel density of superficial retinal capillary plexus (SCP) and deep retinal capillary plexus (DCP) in 3 mm×3 mm macular area were measured by optical coherence tomography angiography instrument and compared between different groups.The correlation between BCVA, CMT and microvascular structural parrameters in ME eyes of CRVO patients was analyzed by Pearson linear correlation test.This study protocol adhered to the Declaration of Helsinki and was approved by the Ethics Committee of The Second Affiliated Hospital of Chongqing Medical University (No.2018-211).Written informed consent was obtained from each subject before any medical examination.Results:Compared with contralateral eyes, the FAZ area and FAZ perimeter of ME eyes were significantly increased, and AI, the vessel density of SCP and DCP were significantly decreased (all at P<0.01).Compared with normal control eyes, the FAZ area and FAZ perimeter of contralateral eyes of CRVO patients were significantly increased, and AI, the vessel density of DCP were significantly decreased (all at P<0.05).In ME eyes, the BCVA LogMAR was positively correlated with FAZ area and FAZ perimeter ( r=0.614, 0.609; both at P<0.05), and was negatively correlated with AI and vessel density of SCP ( r=-0.517, -0.593; both at P<0.058).In ME eyes, CMT was positively correlated with FAZ area and FAZ perimeter ( r=0.523, 0.610; both at P<0.05), and was negatively correlated with AI and the vessel density of SCP ( r=-0.537, -0.608; both at P<0.05). Conclusions:The characteristic microvascular change in ME secondary to CRVO eyes is the decrease of blood flow caused by the decrease of capillaries in fovea, and the same change in blood flow also exists in their contralateral eyes.The degree of ME and visual function damage are correlated with the degree of foveal damage and the blood flow in fovea.
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@#AIM: To investigate the risk factors of neovascular glaucoma(NVG)after central retinal vein occlusion(CRVO), and to construct a predictive model.<p>METHODS: The clinical data of 483 patients(527 eyes)with CRVO admitted to the Department of Ophthalmology of our hospital from February 2016 to March 2020 were retrospectively selected and followed up until June 2021. CRVO combined with NVG were counted.The risk prediction model of NVG after CRVO was constructed according to the regression coefficient of risk factors, and the Hosmer-Lemeshow(<i>H-L</i>)test and receiver operating characteristic(ROC)curve method were used to evaluate the prediction model.<p>RESULTS: Fifteen patients(23 eyes)were followed up with 35(15-64)mo. NVG was happened in 70 patients(86 eyes)(NVG group)and no NVG was happened in 398 patients(418 eyes)(non-NVG group). Regression analysis showed that ischemic CRVO, IOP≥18mmHg at the first visit, hypertension,relative afferent pupillary defect(RAPD)≥0.75logU at the first visit, uncorrected visual acuity(UCVA)>0.30(LogMAR)at the first visit were risk factors for NVG after CRVO(<i>P</i><0.01), and anti-vascular endothelial growth factor(VEGF)therapy were protective factors for NVG after CRVO(<i>P</i><0.01). The risk prediction model for NVG after CRVO had good consistency(<i>H-L</i> test <i>P</i>>0.05)and discrimination(area under the curve was 0.877, 95%<i>CI</i>:0.830-0.924, sensitivity was 84.3%, specificity was 88.9%). The predictive scoring model was further constructed, and the critical value of NVG after CRVO was 5 points,the area under the curve was 0.844(95%<i>CI</i>:0.790-0.898), sensitivity was 78.6%, and specificity was 87.4%.<p>CONCLUSION: Ischemic CRVO, IOP≥18mmHg at the first visit,hypertension,RAPD≥0.75logU at the first visit, UCVA>0.30(LogMAR), and anti-VEGF therapy are closely related to NVG after CRVO, and the predictive model established on this basis has good predictive efficacy.
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@#AIM: To investigate the clinical effectiveness of conbercept intravitreal injection combined with panretinal photocoagulation for ischemic central retinal vein occlusion.<p>METHODS: A retrospective study has been conducted on 80 patients(80 eyes)of ischemic central retinal vein occlusion diagnosed and treated at Dalian No.3 People's Hospital from January 2017 to January 2019. These 80 patients have been divided into two groups based on treatment methods. In Group A, 40 patients(40 eyes)were given 3+PRN intravitreal injection of conbercept combined with panretinal photocoagulation. In Group B, 40 patients(40 eyes)accepted the treatment of 3+PRN intravitreal injection with conbercept. The best corrected visual acuity(BCVA)and central macular thickness(CMT)before and after treatment were recorded respectively at 3mo, 6mo and 12mo, and the clinical effectiveness and adverse reactions were observed and documented.<p>RESULTS: After 12mo: In group A, BCVA improved from 1.05±0.58 to 0.41±0.37(<i>P</i><0.01).In group B, BCVA improved from 0.98±0.51 to 0.63±0.53(<i>P</i><0.01). There was no significant difference between the two groups(<i>P</i>>0.05). In group A, CMT changed from 592.30±79.75μm to 260.08±86.23μm(<i>P</i><0.01). In group B, CMT changed from 604.98±81.73μm to 406.83±162.97μm(<i>P</i><0.01).CMT was better in Group A than Group B(<i>P</i><0.01). The mean number of injections in group A(3.15±0.43 times)and group B(3.83±1.06 times)was statistically significant(<i>P</i><0.01). During follow-up, no adverse events happened in Group A. Two patients were neovascular glaucoma after central retinal vein occlusion in Group B.<p>CONCLUSION:It is safe and effective to use intravitreal injection of conbercept to treat central retinal vein occlusion. Combining intravitreal injection of conbercept with panretinal photocoagulation can significantly improve BCVA, lead to further regression of macular edema and a more stabilized positive effect. It proves to reduce recurrence rate of the central retinal vein occlusion and decrease the chances of any complications.
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@#AIM: To explore the correlation between age, OCT characteristics and the efficacy of anti-vascular endothelial growth factor(VEGF)drugs in the treatment of macular edema secondary to central retinal vein occlusion(CRVO).<p>METHODS: Retrospective case-control study. From July 2017 to July 2019,47 eyes of 47 patients with CRVO were included and divided into group A(elderly group, age>50y, <i>n</i>=27)and group B(young and middle-aged group, age≤50y, <i>n</i>=20). All patients were received anti-VEGF therapy(3+PRN)and followed up for at least 12mo. The best corrected visual acuity(BCVA), the number of hyper-reflective dots(HRD), the average retinal thickness(ART)and central retinal thickness(CRT)were observed before and after treatment. The number of injections, the recovery rate of outer membrane(ELM)and ellipsoidal zone(EZ)were compared between the two groups, and the related indexes affecting visual prognosis were analyzed. <p>RESULTS: After anti-VEGF treatment, BCVA was improved, the number of HRD decreased, CRT and ART thinned in both groups. During the follow up of 12mo after treatment, the frequency of injection of anti-VEGF drugs in the elderly group was higher than that in the young and middle-aged group(8.4±2.1 times <i>vs</i> 7.3±1.7 times, <i>P</i>=0.047), but there was no difference in the recovery rates of ELM and EZ between the two groups. BCVA in the elderly group was correlated with the age, HRD, ELM and EZ(all <i>P</i><0.05). BCVA was correlated with age, ART, HRD, ELM and EZ in young and middle-aged patients(all <i>P</i><0.05). <p>CONCLUSION: Intravitreal injection of anti-VEGF drugs can effectively treat macular edema secondary to CRVO and the prognosis of young and middle-aged patients is better than that of elderly patients. Age and OCT indexes such as HRD, ELM and EZ are related to visual prognosis.
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@#AIM: To investigate the clinical effect of non-invasive positive pressure ventilation in patients with nonischemic central retinal vein occlusion(RVO)combined with severe obstructive sleep apnea hypopnea syndrome.<p>METHODS: A retrospective analysis was performed on 66 patients(66 eyes)with nonischemic central retinal vein occlusion combined with severe obstructive sleep apnea hypopnea syndrome in our hospital from December 2017 to December 2018. 30 of the patients(30 eyes)received intraocular anti-vascular therapy with Lucentis and retinal laser irradiation therapy combined with noninvasive positive pressure ventilation(observation group). Totally 36 patients(36 eyes)only received intraocular anti-vascular therapy with Lucentis and retinal laser irradiation therapy(control group). The differences of the best corrected visual acuity(BCVA)and retinal thickness at lesion sites were compared and analyzed between two groups before treatment and at the 1mo, 3mo and 6mo after treatment.<p>RESULTS: There were statistically significant differences of both retinal thickness and BCVA between two groups at different time points(<i>P</i><0.05). Both retinal thickness and BCVA of the observation group were lower than those of the control group at the 3 and 6mo after treatment(<i>P</i><0.01). There was no significant difference between the retinal thickness of the 3mo after treatment and that of the 6mo after treatment in the control group(<i>P</i>>0.05), while there were significant differences of retinal thickness between two groups of the other time points in the control group or any two groups of the time points in the observation group(<i>P</i><0.05); BCVAs of the 1, 3 and 6mo after treatment were significantly lower than that of before treatment in the observation group(<i>P</i><0.05), while the BCVAs of the 3, 6mo after treatment were significantly higher than that of the 1mo after treatment in the control group(<i>P</i><0.05), but no significant difference of BCVA was observed between any two group of the other time points in the observation group or control group(<i>P</i>>0.05).<p>CONCLUSION: Noninvasive positive pressure ventilation is beneficial for patients with nonischemic(RVO)combined with severe obstructive sleep apnea hypopnea syndrome to improve the therapeutic effect.
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@#AIM: To investigate the effect of panretinal photocoagulation(PRP)combined with intravitreal injection of conbercept as an adjuvant to neovascular glaucoma secondary to central retinal vein occlusion(CRVO). <p>METHODS: This was a prospective case-control study. Patients diagnosed with neovascular glaucoma(stage Ⅰor Ⅱ)secondary to CRVO in our hospital from January 2014 to March 2019 were enrolled and randomly divided into two groups. Patients in combination group were treated with both PRP and intravitreal conbercept injection. In the other group(PRP only group)patients were treated with PRP only. Changes of best corrected visual acuity(BCVA), intraocular pressure(IOP)and iris neovascularization(NVI)were observed before treatment, 1wk, 1mo, 3mo, 6mo and 9mo after treatment.<p>RESULTS: Sixty patients 60 eyes were enrolled, with the mean age of 54.45±6.08 years. 56.67% were males. There were no significant difference between two groups in age and gender. After treatment, all the indexes of the two groups improved obviously with significant different(<i>F</i>=154.992, 92.519, 30.696, 82.374, all <i>P</i><0.001), visual acuity improved, IOP decreased, and NVI decreased at different time points. The difference was statistically significant compared with the control group one week after treatment(<i>F</i>=50.870, 24.265, 13.125, 11.829, all <i>P</i><0.001), and it was maintained continuously.<p>CONCLUSION: For eyes with CRVO secondary with neovascular glaucoma, intravitreal injection of conbercept combined with panretinal photocoagulation PRP is better than panretinal photocoagulation PRP only.
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@#AIM: To analyze the therapeutic effects of anti-vascular endothelial growth factor(VEGF)drugs on patients with macular edema secondary to central retinal vein occlusion(CRVO-ME)in different age groups.<p>METHODS: The study retrospectively reviewed 102 patients(102 eyes)with CRVO-ME treated with intravitreal injection of ranibizumab in ophthalmology department of the hospital between February 2017 and March 2019. The subjects were divided into CM1 group(under 50 years old, 50 cases, 50 eyes)and CM2 group(50 years old or older, 52 cases, 52 eyes), and were followed up for 12mo after treatment. The best corrected visual acuity(BCVA), central macular thickness(CMT), intraocular pressure, average injection times, first injection interval, and complications were recorded.<p>RESULTS: After treatment, the BCVA of both groups was improved, and the CMT decreased. Besides, CM1 group had better BCVA and CMT than CM2 group at 9mo and 12mo(<i>P</i><0.001). At 1mo, 2mo, and 3mo, the intraocular pressure of both groups was higher than that before treatment(<i>P</i><0.01). The intraocular pressures of both groups was lower at 6mo and 9mo than at 3mo after treatment(<i>P</i><0.05), which returned to the pre-treatment level at 12mo(<i>P</i>>0.05). Additionally, CM1 group had lower intraocular pressure than CM2 group at 1mo, 2mo, and 3mo after treatment(<i>P</i><0.01). The average injection times in CM1 group was(3.24±0.35), more than(2.38±0.26)in CM2 group, and the first injection interval(1.75±0.19mo)was shorter than(4.13±0.42mo)in CM2 group(<i>P</i><0.01). No serious complications such as cataract aggravation, retinal detachment, and endophthalmitis were observed in the two groups during follow-up.<p>CONCLUSION: The treatment with anti-VEGF drugs(ranibizumab)for CRVO-ME can significantly improve the patients' visual acuity, and reduce CMT. The condition can be significantly improved within 1mo after injection, without significant influence on intraocular pressure. Compared with patients over 50 years old, patients under 50 years old can obtain better results after treatment with ranibizumab, more significant improvement of visual acuity, significantly thinner CMT, smaller intraocular pressure fluctuations and shorter first injection interval.
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Introduction: Retinal vein occlusion (RVO) is a major causeof vision loss. Of the two main types of RVO, Branch RetinalVein Occlusion (BRVO) is 4 to 6 times more prevalent thanCentral Retinal Vein Occlusion (CRVO), and is the mostcommon type of RVO. Risk factors evaluated in this studyinclude Age, Sex, Hypertension, Diabetes Mellitus, PrimaryOpen Angle Glaucoma (POAG), Tobacco consumption inany form, Dyslipidemia, Hyperhomocysteinemia and Irondeficiency Anaemia (IDA). Current research aimed to studythe risk factors associated with Retinal Venous Occlusivediseases and to study correlation of occurrence of lesions withthese risk factors.Material and methods: This was a hospital based crosssectional study involving 60 cases diagnosed with RetinalVenous Occlusions who were further evaluated for the abovementioned risk factors. Results were evaluated by Unpaired ttest, Fisher test, student ‘t’ test and Chi-Square test. ‘p’ valueless than 0.05 was taken as significant.Results: BRVO (n=49), CRVO (n=11). Most common comorbidity was hypertension, which was found to be significant(p<0.05). Diabetes, dyslipidemia, tobacco in any form,iron deficiency anaemia were not found to be significant.Hyperhomocystemia was found to be significant (p<0.05)under 40 years of age and insignificant risk factor above 40years. Presence of POAG with a duration of more than 5yearswas significant factor in CRVO but not in BRVO.Conclusion: Age and hypertension are significant risk factorsfor RVO. Hyperhomocysteinemia is a significant risk factorfor RVO in patients below 40 years on age. POAG is a riskfactor for development of CRVO. Presence of multiple riskfactors increases the chances of development of RVO.
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Introduction: Venous obstructive disease of the retina iscausing significant visual morbidity affecting quality of lifeof patient. Incidence of CRVO is 0.8 per 1000 persons and 4.4per 1000 persons for BRVO. RVO most commonly affects thevenous blood supply of entire retina [CRVO] or a quadrantdrained by one of the branches [BRVO] less commonlysuperior or inferior half of retina alone is affected [HRVO].Study Aimed to study demographic characteristics and riskfactors of Retinal Vein Occlusions (Both CRVO and BRVO)Material and methods: This is a cross sectional observationstudy. It included 208 patients [64 CRVO patients and 144BRVO patients]at Retina department, Sarojini Devi EyeHospital, Hyderabad. Study was conducted for 1 year and 7months.Results: Hypertension stands alone as the most significantrisk factor (P Value is 0.005). Other factors studied likeUrban Background, Lack of physical Activity, Diabetes,Hyperlipidemias, CVA, CAD etc. though were present in goodnumbers in the cases studied but they were not statisticallysignificant.Conclusion: Hypertension, Diabetes and Raised SerumLipids are significant risk factors for Retinal Vein Occlusionsin South Indian population
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@#AIM: To investigate the efficacy and safety of conbercept intravitreal injection combined with selective laser photocoagulation for central retinal vein occlusion(CRVO).<p>METHODS: A retrospective study was performed on 66 patients with CRVO in our department of ophthalmology. Among them, 30 patients received only conbercept's intravitreal injection and served as a control group. On this basis, another 36 patients were combined with selective laser photocoagulation and as an observation group. The differences of central macular thickness(CMT), BCVA(LogMAR)and complication rate after treatment were compared between the two groups.<p>RESULTS:The CMT and BCVA of the two groups were significantly improved after treatment(<i>P</i><0.05). The CMT and BCVA of the observation group were significantly better than the control group at 6th month after treatment(<i>P</i><0.05). The number of intravitreal injections in the observation group was significantly lower than that in the control group(<i>P</i><0.05). There was no significant difference in the complications(<i>P</i>>0.05).<p>CONCLUSION: The combination therapy has a more significant effect on CRVO and is safe.
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Introducción: la Macroglobulinemia de Waldenström (MW) es un tipo raro de linfoma de células B caracterizado por la proliferación de células linfoplasmocíticas que secretan altas cantidades de inmunoglobulinas M (IgM) monoclonales. Puede presentarse con una amplia gama de síntomas, entre ellos los derivados del aumento de la viscosidad plasmática. Métodos: reportamos un caso de MW que presentó una trombosis de la vena central de la retina (TVCR) bilateral en el contexto de un síndrome de hiperviscosidad (SHV). El objetivo de este trabajo fue revisar algunos aspectos clínicos de la MW, con especial énfasis en el SHV y la TVCR. Resultados: las manifestaciones clínicas y de laboratorio de la MW son inespecíficas y comunes a otras neoplasias hematológicas. El SHV se produce cuando los niveles de IgM sobrepasan los 3 mg/dL, situación que ocurre en un 15-30 por ciento de los pacientes. La TVCR es una complicación grave y rara asociada al SHV, presentándose típicamente como una pérdida de agudeza visual indolora. El fondo de ojo exhibe signos característicos, como tortuosidad venosa y hemorragias retinales hasta la periferia, y la angiografía con fluorosceína y la OCT pueden orientar al diagnóstico y guiar el manejo. El tratamiento incluye la plasmaféresis y tratamientos oftalmológicos basados en agentes antioangiogénicos. Conclusión: la MW es una enfermedad incurable. Sin embargo, es importante sospechar una TVCR en pacientes que debutan con una pérdida de agudeza visual, ya que existen tratamientos efectivos en el manejo de esta complicación. (AU)
Introduction: Waldenstrom's Macroglobulinemia (WM) is a rare type of B-cell lymphoma characterized by proliferation of lymphoplasmocitarian cells that secrete high amounts of monoclonal immunoglobulin M (IgM). It may present with a wide range of symptoms, including the ones that derivatives of the increase in plasma viscosity. Methods: we report a case of WM that presented a bilateral central retinal vein occlusion (CRVO) in the context of a hyperviscosity syndrome (HVS). The objective of this study was to review clinical aspects of the WM, with special emphasis on the HVS and the CRVO. Results: the WM laboratory and clinical manifestations are common to other hematological malignancies. The HVS occurs when levels of IgM exceed 3 mg/dL, situation that occurs in 15-30 percent of patients. The CRVO is a serious and rare complication associated with the HVS, typically presented as a painless visual acuity loss. The fundoscopic examination exhibits characteristic signs, such as venous tortuousity and retinal hemorrhages in all four quadrants and most numerous in the periphery; angiography with fluoroscein and the OCT can orientate the diagnosis and guide the management. The treatment includes plasmapheresis and other ophthlamological treatments based on antiangiogenic agents. Conclusion: the WM is an incurable disease. However, it is important to suspect a CRVO in patients who made their debut with a loss of visual acuity, since there are effective treatments in the management of this complication.(AU)
Subject(s)
Humans , Retinal Vein Occlusion , Waldenstrom Macroglobulinemia , Therapeutics , ViscosityABSTRACT
@#Central retinal artery occlusion and central retinal venous occlusion are rare entities of retinal vascular disorders that can cause sudden visual loss and combined occurrence results in devastating outcomes. The role of protein C deficiency is well established in venous thrombosis however the occurrence of concurrent arterial thrombosis is rare and the combination in association with carotid artery occlusion is an exceptionally rare occurrence. Here we report a case of protein C deficiency presenting as combined central retinal artery occlusion and central retinal venous occlusion with bilateral carotid artery disease
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@#Neovascular glaucoma(NVG)is a refractory blinding eye disease that adds a heavy burden to society. The incidence of neovascular glaucoma is related to a variety of factors, such as retinal ischemia and hypoxia, inflammation and trauma. There are more than 40 diseases that can cause it to occur, among which the most common in clinical is diabetic retinopathy and central retinal vein occlusion. Because of its complex etiology and the pathogenesis remains unclear, clinical treatment is extremely difficult. This paper summarizes some related researches in recent years. Finally, the onset and treatment of neovascular glaucoma are elaborated in order to be expected to help clinical work.