Analysis of macular microcirculation and structural features of retinal branch vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyse the characteristic of macular microcirculation and structural features detected by optical coherence tomography angiography(OCTA)in retinal branch vein occlusion(BRVO), and analyse the risk factors of visual acuity(VA).<p>METHODS: Eligible eyes from subjects(92 with BRVO and 38 healthy people)were included. The relationship between factors and VA was analyzed by retrospective. Vessel density affected by vein occlusion of 3×3mm2 centered on the fovea(3×3mm VD)and foveal vessel density(foveal VD)in the superficial capillary plexus(SCP)and deep capillary plexus(DCP), were measured by OCTA. Central macular thickness(CMT), neuroepithelial layer thickness and height of subcortical fluid in patients with BRVO were measured.<p>RESULTS: The DCP, SCP, FD300, density of superficial fovea, density of superficial fovea and AI of the BRVO group were significantly different with control group(<i>P</i><0.01). Multivariate regression: Age(<i>P</i>=0.033, <i>OR</i>=1.152, 95%<i>CI</i>=1.011-1.312). Density of superficial fovea(<i>P</i>=0.010, <i>OR</i>=1.260, 95%<i>CI</i>=1.056-1.504)and Macular fovea thickness(<i>P</i><0.01, <i>OR</i>=1.033, 95%<i>CI</i>=1.021-1.045)were risk factors of VA. DCP and SCP were negatively related with CMT and neuroepithelial layer(<i>P</i><0.01). CMT was positively correlated with the thickness of neuroepithelial layer and the height of subcortical fluid(<i>P</i><0.01).<p>CONCLUSION: Using OCTA, we can observe the BRVO retinal blood flow and the changes of the structure of the retinal section, and the pathological features of macular retina in BRVO patients can be observed more comprehensively. Age, density of superficial fovea and macular fovea thickness were risk factors of VA.

Clinical efficacy of compound anisodine injection combined with anti-VEGF in the treatment of macular edema due to branch retinal vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the efficacy and safety of compound anisodine injection combined with anti-VEGF therapy in treatment of macular edema of branch retinal vein occlusion.<p>METHODS: Sixty patients with retinal vein occlusion were randomly divided into the combined group and the control group. The control group was treated with a conventional anti-VEGF injection. The combined group was treated with compound anisodine and anti-VEGF injection. Treatment of compound anisodine: one injection per day, after 14d of injections pause for 14d, a total of 28 injections. Compare the therapeutic effects and safety of the two groups.<p>RESULTS:After anti-VEGF combined with compound anisodine and VEGF treatment, the visual acuity of the two groups were significantly increased(<i>F</i>_time=185.05, <i>P</i>_time<0.001; <i>F</i>_group=3.34, <i>P</i>_group=0.025); The CRT of the two groups were significantly decreased after treatment(<i>F</i>_time=286.2, <i>P</i>_time<0.001; <i>F</i>_group=12.46, <i>P</i>_group<0.001)and there was significantly difference between the control group and the combined group. However, there was no significant difference in visual acuity and CRT between the two groups on the 15^th day of treatment.<p>CONCLUSION: Compound anisodine combined with anti-VEGF therapy can improve the therapeutic effect in patients with retinal vein occlusion.

Efficacy of intravitreal ranibizumab combined with laser photocoagulation for the treatment of macular edema induced by ischemic branch retinal vein occlusion / 眼科新进展

Objective To observe the therapeutic efficacy of intravitreal ranibizumab combined with laser photocoagulation for the treatment of macular edema associated with ischemic branch retinal vein occlusion (BRVO).Methods Together 60 patients (60 eyes) with BRVO in Anshan City Central Hospital were included and divided into three groups,20 patients with intravitreal ranibizumab treatment as A group,20patients with retinal laser photocoagulation treatment as B group,and another 20 patients with intravitreal ranibizumab combined with retinal laser photocoagulation therapy as C group,followed by the preoperative observation of the best corrected visual acuity (BCVA),slit lamp,fundus and intraocular pressure examination,fundus fluorescein angiography (FFA),optical coherence tomography (OCT).One day after the surgery,BCVA,slit lamp and intraocular pressure examination were conducted,and 1 month,2months,3 months after the surgery,observation of BCVA,slit lamp,fundus and intraocular pressure examination were performed.Then,OCT was used to determine the status of macular edema.And finally,BCVA and central macular thickness (CMT) in the three groups were statistically analyzed by observing the above indicators.Results The BCVA at 1 month,2 months,and 3 months after treatment was higher than before treatment in all three groups,and the differences were statistically significant (all P ＜ 0.05).The BCVA of A group was 0.26 ±0.14 and 0.26 ±0.14 at 2 and 3 months after treatment,respectively,which was significantly better than that of B group (0.39 ±0.10 and 0.40 ±0.10) (all P ＜0.05).At 3 months after treatment,the BCVA in C group was 0.14 ±0.11,which was significantly higher than that in A group (0.26 ±0.14) (P＜0.05).The BCVA of C group was 0.30 ±0.13,0.20 ±0.12,0.14 ± 0.11 at 1 month,2 months and 3months after treatment,respectively,which was better than that of B group (0.43 ±0.10,0.39 ± 0.10,0.40 ± 0.10),and the differences were statistically significant (all P ＜0.05).The postoperative CMT was significantly reduced when compared with preoperation in all three groups (all P ＜ 0.05).The CMT at 1 month,2 months and 3 months after treatment in C group was (318.85 ± 71.48)μm,(287.15 ± 56.71) μm and (255.05 ± 60.90)μm,respectively,which was better than that in A group [(347.00 ± 67.59) μm (305.10 ± 47.44) μm and (282.40 ± 36.26) μm],and B group [(417.05 ± 63.94) μm,(394.80 ±57.18) μm,and (375.90 ± 55.10) μm],with significant differences (all P ＜ 0.05).At 2 months and 3 months after treatment,CMT in A group was better than that in B group,and the difference was statistically significant (P ＜ 0.05).Conclusion The efficacy of retinal laser photocoagulation combined with intravitreal ranibizumab in the treatment of BRVO macular edema is better than simple retinal laser photocoagulation and simple intravitreal ranibizumab.

Intravenous Thrombus Formation in Branch Retina Vein Occlusion

PURPOSE: It is very rare to observe the thrombus formation next to the ateriovenous crossing(AV crossing) in branch retinal vein occlusion(BRVO). We investigated two cases with the thrombus in BRVO. MATERIALS AND METHODS: Two of 347 cases with BRVO to perform the fluorescein angiography(FAG) were observed to form the intravascular thrombus next to the AV crossing. RESULTS: The vascular wall in the area of thrombus was hyperfluorescent in FAG. The fluorescence was visible in the early arteriovenous phase and it increased in the mid-phase of the angiogram. Investigatons for systemic hypertension and hyperlipidemia in two cases were positive. The vascular wall in the area of thrombus in one case revealed as hyperfluorescence exaggeratedly in length by forward and backward movement of the thrombus during performing FAG. And the leakage of fluorescein from the venule next to the AV crossing was not observed. In the other case, the vascular wall in the area of thrombus revealed the small hyperfluorescent spot and the leakage of fluorescein. CONCLUSIONS: The pathogenesis of thrombus formation in the retinal vein resulting in retinal vein occlusion is not well understood. Although poststenotic turbulence of blood flow after an AV crossing or a preexisting vessel wall alteration combined with alterations of blood fluidity may induce thrombus formation, it was uncertain in our cases whether or not the thrombus formation was associated with hyperlipidemia, systemic hypertension, and hypercoaguable states.

Clinical Study on The Vitreous Hemorrhage

Vitreous hemorrhage acounted for 64 patients(67 eyes) seen during a eighteenmonth period from March 1, 1987, to August 31, 1988. In order of decreasing frequency, the major causes were diabetic retinopathy(19.4%), trauma(l1.9%), silent retinal tear(10.4%). retinal branch vein occlusion(7.5%), acute posterior vitreous detachment(7.5%), Eales' disease(6%), Hypertension(6%), central retinal vein occlusion(4.4%). And the minor causes were rhegmatogenous retinal detachment(3%), retinal angioma(3%), chronic renal failure(3%), subretinal neovascularization(1.5%), disc neovascularization with undetermined cause(1.5%). No cause could be determined in 14.9% of the cases.