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Showing papers on "Retinal Vein published in 2021"


Journal ArticleDOI
TL;DR: In this paper, a 32-year-old healthy male presented with a paracentral scotoma, retinal hemorrhages, and dilated and tortuous retinal vessels inferiorly in the right eye.

23 citations


Journal ArticleDOI
TL;DR: In this article, a systematic review has comprehensively summarized all retinal manifestations secondary to COVID-19 disease recorded till date since the beginning of the pandemic, using the PRISMA statement.
Abstract: The pandemic of COVID-19 has been caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Apart from respiratory malfunction, COVID-19 causes a system-wide thromboembolic state, leading to serious cardiovascular, cerebrovascular and peripheral vascular manifestations. However, our knowledge regarding retinal manifestations due to systemic COVID-19 is minimal. This systematic review has comprehensively summarized all retinal manifestations secondary to COVID-19 disease recorded till date since the beginning of the pandemic. All studies published till November 27, 2020, which have reported retinal manifestations in COVID-19 patients were systematically reviewed using the PRISMA statement. We included 15 articles: 11 case reports and four cross-sectional case series. The most commonly reported manifestations which did not affect visual acuity were retinal hemorrhages and cotton wool spots. The most common vision threatening manifestation was retinal vein occlusion with associated macular edema. Rarely, patients may also present with retinal arterial occlusions and ocular inflammation. These manifestations may occur from as soon as within a week after the onset of COVID-19 symptoms to more than 6 weeks after. Mostly causing milder disease, COVID-19 may however lead to severe life-threatening thromboembolic complications, and systemic antithrombotic therapy has been suggested as a prophylactic and therapeutic management strategy for patients affected with serious systemic disease. However, both sick and apparently healthy patients may suffer from various retinal complications which may lead to loss of vision as well. No consensus regarding management of retinal complications with anticoagulants or anti-inflammatory medications have been proposed; however, they may be tackled on individual basis.

22 citations


Journal ArticleDOI
TL;DR: In this article, inflammatory and oxidative stress play prominent roles in the pathogenesis of many degenerative diseases of the retina, such as age-related macular degeneration (AMD), diabetic retinopathy (DR), retinal vein occlusion, and retinitis pigmentosa.
Abstract: Inflammation and oxidative stress play prominent roles in the pathogenesis of many degenerative diseases of the retina, such as age-related macular degeneration (AMD), diabetic retinopathy (DR), retinal vein occlusion, and retinitis pigmentosa [...].

16 citations


Journal ArticleDOI
TL;DR: In this paper, the authors reviewed the multimodal imaging and therapeutic strategies for eyes with RVO with the hope that it provides better understanding of the pathology and leads to the development of new therapies.
Abstract: The technologies of ocular imaging modalities such as optical coherence tomography (OCT) and OCT angiography (OCTA) have progressed remarkably. Of these in vivo imaging modalities, recently advanced OCT technology provides high-resolution images, e.g., histologic imaging, enabling anatomical analysis of each retinal layer, including the photoreceptor layers. Recently developed OCTA also visualizes the vascular networks three-dimensionally, which provides better understanding of the retinal deep capillary layer. In addition, ex vivo analysis using autologous aqueous or vitreous humor shows that inflammatory cytokine levels including vascular endothelial growth factor (VEGF) are elevated and correlated with the severity of macular edema (ME) in eyes with retinal vein occlusion (RVO). Furthermore, a combination of multiple modalities enables deeper understanding of the pathology. Regarding therapy, intravitreal injection of anti-VEGF drugs provides rapid resolution of ME and much better visual improvements than conventional treatments in eyes with RVO. Thus, the technologies of examination and treatment for managing eyes with RVO have progressed rapidly. In this paper, we review the multimodal imaging and therapeutic strategies for eyes with RVO with the hope that it provides better understanding of the pathology and leads to the development of new therapies.

16 citations


Journal ArticleDOI
TL;DR: Results suggest lack of association between CBC-derived inflammatory indices and RVO and suggest MPV and, to a lesser extent, RDW may be disease biomarkers in RVO.
Abstract: To evaluate the role of some complete blood cell count (CBC)-derived measures in retinal vein occlusion (RVO). This was a retrospective case-control study, including 127 newly diagnosed RVO patient...

14 citations


Journal ArticleDOI
01 Oct 2021-Eye
TL;DR: Wide-field optical coherence tomography angiography (WF-OCTA) may become a useful noninvasive tool in the detection of neovascularization in patients with ischemic RVO and the characterization of different morphologies of nevascularization detected by WF-O CTA could be of clinical relevance.
Abstract: Background/objectives Abnormal retinal neovascularization caused by ischemic retinal vein occlusion (RVO) is a frequent cause of visually significant vitreous hemorrhage. The early detection of new vessels may be challenging and often requires the use of invasive tests such as fundus fluorescein angiography (FA). We demonstrate the use of wide-field optical coherence tomography angiography (WF-OCTA) in the detection and characterization of neovascularization secondary to ischemic RVO. Subjects/methods We conducted a retrospective observational case series of patients diagnosed with ischemic RVO between August 2018 and March 2019, who underwent WF-SS-OCTA imaging (PLEX Elite 9000, Carl Zeiss Meditec). We performed real-life montage imaging, covering the involved area and compared the findings of WF-SS-OCTA to standard clinical examination and when available, ultrawide-field fluorescein angiography (UWF-FA, Optos 200TX). Results In the included 39 eyes with ischemic RVO, neovascularization elsewhere (NVE) was encountered in 16 of 39 eyes (41%) on WF-OCTA and were characterized as sea-fan type vessels and nodular type vessels, based on their appearance and localization. NVE was identified in 4/39 eyes on standard clinical examination, equating to a detection rate of 10.3%. All were of a sea-fan morphology. In one case, NVE found on WF-OCTA was not observed on UWF-FA, which was a nodular type. Neovascularization of the disc (NVD) was detected in one eye. Conclusions WF-OCTA may become a useful noninvasive tool in the detection of neovascularization in patients with ischemic RVO. Furthermore, the characterization of different morphologies of neovascularization detected by WF-OCTA could be of clinical relevance.

14 citations


Journal ArticleDOI
TL;DR: A systematic review and meta-analysis of standard indices of platelet activation in retinal vein occlusion and its subtypes found mean platelet volume and platelet distribution width are significantly elevated in RVO.
Abstract: PURPOSE: Platelet count, mean platelet volume, platelet distribution width, and plateletcrit are standard indices of platelet activation that have been studied in retinal vein occlusion (RVO) and its subtypes: branch retinal vein occlusion and central retinal vein occlusion. This systematic review and meta-analysis aimed to assess the association between these platelet parameters and RVO. METHODS: We searched for studies investigating the association between these platelet indices and RVO in multiple online databases from inception to August 2020. Mean differences and the associated confidence intervals were obtained and calculated for each included study and pooled using random-effects inverse variance modeling. Meta-regression was used to explore interstudy and intrastudy heterogeneity. RESULTS: Thousand three hundred and twenty-five unique studies were screened, from which 24 studies encompassing 2,718 patients were included. Mean platelet volume and platelet distribution width were significantly elevated in RVO, with pooled mean differences of 0.45 fL (95% CI 0.24-0.66, P < 0.0001) and 1.43% (95% CI 0.57-2.29, P = 0.0011), respectively. Platelet count and plateletcrit were not significantly associated with RVO. Mean platelet volume was also independently elevated in branch retinal vein occlusion and central retinal vein occlusion. CONCLUSION: Mean platelet volume and platelet distribution width are significantly elevated in RVO. Further research is required to explore the independence and potential prognostic significance of these associations.

13 citations


Journal ArticleDOI
TL;DR: In this paper, the authors investigated the association of age, gender, and laterality with the onset frequency of retinal vascular occlusion subtypes and found various subtype-specific disease-onset differences related to gender and ocular laterality.

13 citations


Journal ArticleDOI
TL;DR: The terminology ‘Henle fiber layer hemorrhage (HH)’ is proposed to describe the clinical and OCT findings, which may result from abnormal retinal venous pressure from systemic or local retinovascular disorders affecting the deep capillary plexus or from choroidal vascular abnormalities.
Abstract: Background To describe the clinical presentation and characteristic imaging features of deep retinal haemorrhages primarily located in the Henle fibre layer (HFL) of the macula. The spectrum of aetiologies and a comprehensive theory of pathogenesis are presented. Methods This is a retrospective, multicentre case series evaluating eyes with retinal haemorrhage in HFL. Clinical features, underlying aetiology, systemic and ocular risk factors, visual acuity, and multimodal imaging including fundus photography and cross-sectional and en face optical coherence tomography (OCT) are presented. Results Retinal haemorrhages localised to HFL in 33 eyes from 23 patients were secondary to acute blunt trauma to the head (n=2), eye (n=1) and trunk (n=1), ruptured intracranial aneurysm (Terson’s syndrome, n=3), general anaesthesia (n=1), epidural anaesthesia (n=1), hypertension with anaemia (n=1), decompression retinopathy (n=1), postvitrectomy with intraocular gas (n=1), retinal vein occlusion (n=7), myopic degeneration (n=2), macular telangiectasia type 2 (n=1), and polypoidal choroidal vasculopathy (n=1). Defining clinical features included deep retinal haemorrhage with feathery margin and petaloid pattern radiating from the fovea. OCT demonstrated characteristic hyper-reflectivity from the haemorrhage delineated by obliquely oriented fibres in the Henle layer. Spontaneous resolution of HFL haemorrhage occurred after 3 months in 15 patients with follow-up. Conclusion The characteristic petaloid-shaped, deep intraretinal haemorrhage with a feathery margin localised to HFL is associated with various disorders. The terminology ‘Henle fiber layer hemorrhage (HH)’ is proposed to describe the clinical and OCT findings, which may result from abnormal retinal venous pressure from systemic or local retinovascular disorders affecting the deep capillary plexus or from choroidal vascular abnormalities.

12 citations



Journal ArticleDOI
TL;DR: At final observation, median baseline central retinal thickness significantly improved from baseline 538 to 290 μm (p < 0.001) and complete macular edema resolution was achieved in 51.0% of patients.
Abstract: To evaluate the presence of macular edema secondary to retinal vein occlusion (RVO)—both central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO)—3 years after diagnosis in patients who underwent intravitreal therapy and to identify potential prognostic factors and biomarkers of persistent macular edema. National multicenter, observational, exploratory, retrospective cohort study of 104 consecutive patients with macular edema secondary to RVO diagnosed from January 2014 to December 2015 with minimum 3-year follow-up time. Data analyzed included best-corrected visual acuity (BCVA), clinical and demographic data, and spectral domain optical coherence tomography parameters. At final observation, median baseline central retinal thickness significantly improved from baseline 538 to 290 μm (p < 0.001) and complete macular edema resolution was achieved in 51.0% of patients (56.3% and 42.5% in BRVO and CRVO patients, respectively). BCVA also improved (p < 0.01). Logistic regression analysis revealed a relationship between recurrence of macular edema and disorganization of retinal inner layers (DRIL) at baseline (odds ratio = 2.88; p = 0.013). Good long-term anatomical and functional outcomes are achieved with intravitreal treatments in RVO patients. Anatomical success and visual gains seen in the first year were maintained throughout the entire follow-up, though DRIL is a major risk factor for recurrence.

Journal ArticleDOI
TL;DR: In this article, the authors investigated early changes in the choroidal and retinal blood flow using OCTA imaging in a cohort of patients undergoing anti-VEGF intravitreal injections (IVI) for macular edema following retinal vein occlusion and diabetic retinopathy.
Abstract: Whether post injectional acute intraocular pressure (IOP) increase is associated with decreased peripapillary and macular perfusion is still under debate. Here, we investigated early changes in the choroidal and retinal blood flow using OCTA imaging in a cohort of patients undergoing anti-VEGF intravitreal injections (IVI) for macular edema following retinal vein occlusion and diabetic retinopathy. In this prospective single-center, observational study, the pre- and post-IVI changes in retinal perfusion were examined via assessment of vessel length density (VLD) and vessel density (VD) in deep and superficial capillary segmentations (DCP and SCP), foveal avascular zone (FAZ) in SCP, as well as flow signal deficits in the choriocapillaris segmentation. Mean IOP significantly changed over the study course (p = 0.000; ANOVA). Measurements at 5 min post-IVI (33.48 ± 10.84 mmHg) differed significantly from baseline (17.26 ± 2.41 mmHg, p = 0.000), while measurements from one day, one week, and one-month post-IVI did not (p = 0.907, p = 1.000 and p = 1.000 respectively). In comparison to baseline, no changes in OCTA parameters, including FAZ, VD, VLD, and FV, were detected 5 min post-IVI. No significant alterations in OCTA parameters were observed during study course. Increased IOP spikes were detected post-IVI; however, no potential permanent ischemic retinal damage was suspected.

Journal ArticleDOI
01 Jan 2021
TL;DR: EZ and outer retinal integrity are correlated with functional outcomes in RVO and is associated with functional improvement after treatment, following treatment.
Abstract: Purpose:This work evaluated the longitudinal dynamics of ellipsoid zone (EZ) integrity in retinal vein occlusion (RVO) with macular edema and their relation to outcomes.Methods:Clinical characteris...

Journal ArticleDOI
TL;DR: To evaluate the safety and feasibility of robot‐assisted retinal vein cannulation with Ocriplasmin infusion for centralretinal vein occlusion, a novel approach is proposed that combines robot-assisted and human-assisted infusion.
Abstract: Purpose To evaluate the safety and feasibility of robot-assisted retinal vein cannulation with Ocriplasmin infusion for central retinal vein occlusion. Methods Prospective phase I trial including four patients suffering from central retinal vein occlusion (CRVO). Diagnosis was confirmed by preoperative fluo-angiography and followed by a standard three-port pars plana vitrectomy. Afterwards, a custom-built microneedle was inserted into a branch retinal vein with robotic assistance and infusion of Ocriplasmin started. Primary outcomes were the occurrence of intra-operative complications and success of cannulation. Secondary outcomes were change in visual acuity, central macular thickness (CMT) and venous filling times (VFT) during fluo-angiography two weeks after the intervention. Results Cannulation with infusion of ocriplasmin was successful in all four eyes with a mean total infusion time of 355 ± 204 seconds (range 120-600 seconds). Best corrected visual acuity (BCVA) remained counting fingers (CF) in case 3 and 4, increased in case 1 from CF to 0.9LogMAR and decreased in case 2 from 0.4 to 1.3 LogMAR. CMT and VFT both showed a trend towards significant decrease comparing preoperative measurements with two weeks postintervention (1061 ± 541 μm versus 477 ± 376 μm, p = 0.068) and 24 ll 4 seconds versus 15 ± 1 seconds, p = 0.068, respectively). In one eye a needle tip broke and could be removed with an endoforceps. There were no other intervention-related complications. Conclusion Robot-assisted retinal vein cannulation is feasible and safe. Local intravenous infusion with Ocriplasmin led to an improved retinal circulation.

Journal ArticleDOI
TL;DR: The retinal vasculature is the only neurovascular system directly visible to the human eye, easily evaluated by fundoscopy and many imaging modalities, which allows physicians to diagnose and treat retinal pathologies and detect systemic diseases including diabetes, hypertension, hypercoagulable/hyperviscosity syndromes, and vasculitis as discussed by the authors.

Journal ArticleDOI
TL;DR: The ophthalmic effects of acute ICP elevation are mediated by increased intracranial venous pressure producing upstream pressure changes within the orbital and retinal veins, and offer exciting possibilities for the development of non-invasive ocular biomarkers to estimate acute I CP elevations following significant neuro-trauma.
Abstract: Orbital veins such as the retinal veins and episcleral veins drain into the cavernous sinus, an intracranial venous structure. We studied the effects of acute intracranial pressure (ICP) elevation ...

Journal ArticleDOI
TL;DR: The OCTA techniques are reviewed and their ability to detect and diagnose several retinal vascular and optical nerve diseases, such as diabetic retinopathy (DR), anterior ischemic optic neuropathy (AION), age-related macular degeneration (AMD), glaucoma, retinal artery occlusion and retinal vein Occlusion are reviewed.
Abstract: The optical coherence tomography angiography (OCTA) is a noninvasive imaging technology which aims at imaging blood vessels in retina by studying decorrelation signals between multiple sequential OCT B-scans captured in the same cross section. Obtaining various vascular plexuses including deep and superficial choriocapillaris, is possible, which helps in understanding the ischemic processes that affect different retina layers. OCTA is a safe imaging modality that does not use dye. OCTA is also fast as it can capture high-resolution images in just seconds. Additionally, it is used in the assessment of structure and blood flow. OCTA provides anatomic details in addition to the vascular flow data. These details are important in understanding the tissue perfusion, specifically, in the absence of apparent morphological change. Using these anatomical details along with perfusion data, OCTA could be used in predicting several ophthalmic diseases. In this paper, we review the OCTA techniques and their ability to detect and diagnose several retinal vascular and optical nerve diseases, such as diabetic retinopathy (DR), anterior ischemic optic neuropathy (AION), age-related macular degeneration (AMD), glaucoma, retinal artery occlusion and retinal vein occlusion. Then, we discuss the main features and disadvantages of using OCTA as a retinal imaging method.

Journal ArticleDOI
TL;DR: In this paper, the authors present the risk factors of retinal vein occlusion associated with coagulation disorders, as well as the acquired and genetic risk factors for thrombophilia.
Abstract: Retinal vein occlusion (RVO) is a heterogenous disorder in which the formation of a thrombus results in the retinal venous system narrowing and obstructing venous return from the retinal circulation. The pathogenesis of RVO remains uncertain, but it is believed to be multifactorial and to depend on both local and systemic factors, which can be divided into vascular, platelet, and hypercoagulable factors. The vascular factors include dyslipidaemia, high blood pressure, and diabetes mellitus. Regarding the platelet factors, platelet function, mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (PLCR) play key roles in the diagnosis of retinal vein occlusion and should be monitored. Nevertheless, the role of a hypercoagulable state in retinal vein occlusion remains unclear and requires further studies. Therefore, the following article will present the risk factors of RVO associated with coagulation disorders, as well as the acquired and genetic risk factors of thrombophilia. According to Virchow's triad, all factors mentioned above lead to thrombus formation, which causes pathophysiological changes inside venous vessels in the fundus of the eye, which in turn results in the vessel occlusion. Therefore, a diagnosis of retinal vein occlusion should be based on both eye examination and general examination, including laboratory tests.

Journal ArticleDOI
TL;DR: The authors reviewed and summarized studies of the effects of anti-VEGF drugs on retinal ischemia, especially retinal nonperfusion areas (NPAs), especially NPAs.
Abstract: In recent years, retinal ischemia such as that which occurs in diabetic retinopathy (DR) and retinal vein occlusion (RVO) has become a hotspot of ischemic retinopathy research. High levels of vascular endothelial growth factor (VEGF) are recognized as a major cause of macular edema (ME) in DR and RVO. High concentrations of VEGF in the vitreous can lead to serious retinal ischemia and hypoxia and form retinal nonperfusion areas (NPAs). Different levels of retinal ischemia can represent disease severity and progression. Anti-VEGF therapy as the first-line treatment for ME has been found to be effective in improving vision, but there are still disputes about whether anti-VEGF therapy could improve retinal ischemia and achieve reperfusion of previously developed retinal NPAs. Here, we review and summarize studies of the effects of anti-VEGF drugs on retinal ischemia, especially NPAs.

Journal ArticleDOI
TL;DR: The prevalence of CKD increases in RVO patients, especially in CRVO, and in turn, the prevalence of RVO also increases in ESRD patients, suggesting a correlation between RVO and CKD.
Abstract: Objectives:We performed this meta-analysis to assess the correlation of retinal vein occlusion (RVO) and chronic kidney disease (CKD).Methods:We searched PubMed, Embase, Web of Science and Cochrane...

Journal ArticleDOI
TL;DR: Thicker choroid was a feature of naïve RVO patients with SRD and SRD may be an indicator of better anatomical recovery of retina in R VO patients after a single dose of anti-VEGF treatment.
Abstract: To evaluate choroid thickness and macular retinal metrics in treatment naive retinal vein occlusion (RVO) patients with serous retinal detachment (SRD) before and after intravitreal anti-vascular endothelial cell growth factor (VEGF) injection and to elucidate the possible role of choroid in the development of SRD and the potential role of SRD as a prognostic parameter. This is a retrospective study involving 85 RVO patients, 41 central retinal vein occlusion (CRVO), and 44 branch retinal vein occlusion (BRVO), with macular edema: 21 central retinal vein occlusion and 22 branch retinal vein occlusion with SRD and the rest without SRD. Patients were evaluated with ophthalmic examinations and swept-source optical coherence tomography (SS-OCT) both before and 4–6 weeks after intravitreal anti-VEGF treatment. Choroid thickness and retinal metrics were measured and compared between SRD and non-SRD groups within each RVO subtype. In both CRVO and BRVO patients, the mean central subfield foveal thickness (CSFT) and central subfoveal choroid thickness (CSCT) of the SRD groups were thicker than those in the non-SRD groups (p < 0.05) at onset. After one anti-VEGF injection, CSFT and FNRT decreased in all groups (p < 0.05). The CSCTs were thicker in the SRD groups compared with the non-SRD groups (p < 0.05). The mean changes of CSFT were more remarkable in the SRD groups (p < 0.05). Thicker choroid was a feature of naive RVO patients with SRD and SRD may be an indicator of better anatomical recovery of retina in RVO patients after a single dose of anti-VEGF treatment.

Journal ArticleDOI
TL;DR: In this article, the efficacy and safety of Ranibizumab, an anti-VEGF agent, in the real-world setting was studied. But, there was no report of endophthalmitis in any eye and the average number of intravitreal injections was 3.5 per patient.
Abstract: Macular edema secondary to retinal vein occlusion (RVO) is an important cause of loss of vision. Intravitreal injections (IVI) of anti-vascular endothelial growth factor (VEGF) are the standard of care in this disease, as shown in numerous randomized controlled trials. The purpose of this study was to study the efficacy and safety of ranibizumab, an anti-VEGF agent, in the real-world setting. This was 48 weeks, open-label, prospective, multicentre, observational study. Patients diagnosed with ME secondary to RVO were treated with IVI of Ranibizumab 0.5 mg in real-world conditions. Efficacy was measured by improvement seen in best-corrected visual acuity (BCVA) in terms of Early Treatment of Diabetic Retinopathy Study (ETDRS) Letter Scores and change in central retinal thickness (CRT) measured by optical coherence tomography. One hundred eyes of 100 patients (79 with branch retinal vein occlusion and 21 with central retinal vein occlusion) were recruited in the study. The mean (standard deviation, SD) BCVA was 52.8 (21.99) letters at baseline and 62.3 (24.40) letters at week 48. From baseline, there was a significant improvement in BCVA by 7.7 letters (p = 0.001) at 48 weeks. The mean (SD) of CRT was 479.9 (216.25) μm at baseline and it decreased significantly to 284.9 (171.35) μm at week 48 (p < 0.001). During the study period, the average number of intravitreal injections was 3.5 per patient. There was no report of endophthalmitis in any eye. Ranibizumab is well tolerated and effective in treating macular edema secondary to RVO in real-world clinical settings. However, there is under-treatment compared to controlled clinical trials, and the gain in vision is sub-optimal with under-treatment. Clinical Trials Registry - India: CTRI/2015/07/005985 .

Journal ArticleDOI
TL;DR: The retinal vein changes, which can be observed on clinical exam or ophthalmic imaging, are promising non-invasive biomarkers for elevated intracranial pressure (ICP) as a complement to other markers of high ICP including optic nerve head swelling as mentioned in this paper.
Abstract: Retinal vein changes, which can be observed on clinical exam or ophthalmic imaging, are promising non-invasive biomarkers for elevated intracranial pressure (ICP) as a complement to other markers of high ICP including optic nerve head swelling. Animal and human studies have demonstrated increase in retinal vein pressure associated with elevated ICP mediated by increase in cerebral venous pressure, compression of venous outflow by elevated cerebral spinal fluid pressure in the optic nerve sheath, and compression of venous outflow by optic nerve head swelling. Retinal vein pressure can be estimated using ophthalmodynamometry. Correlates of retinal vein pressure include spontaneous retinal venous pulsations, retinal vein diameter, and retinal vein tortuosity. All of these have potential for clinical use to diagnose and monitor elevated ICP. Challenges include diagnostic prediction based on single clinical measurements and accurate assessment of retinal vein parameters in cases where optic nerve head swelling limits visualization of the retinal veins.

Journal ArticleDOI
TL;DR: Topical dorzolamide-timolol may have a beneficial anatomical and functional effect in eyes with macular edema secondary to retinal vein occlusion resistant to treatment.
Abstract: Purpose To evaluate topical dorzolamide hydrochloride-timolol maleate as an adjunct therapy to intravitreous anti-vascular endothelial growth factor injections in eyes with retinal vein occlusion resistant to treatment. Methods Retinal vein occlusion patients with a history of persistent macular edema, despite fixed-interval intravitreous anti-vascular endothelial growth factor injections, were enrolled between April 4, 2016, and June 4, 2017. On enrollment, patients were instructed to administer one drop of topical dorzolamide-timolol twice daily for the duration of the study. They were maintained on the same anti-vascular endothelial growth factor drug and same interval between injections as preenrollment for the subsequent two visits. Primary outcome measures were change in central foveal thickness, central subfield thickness, and thickest macular cut at the final study visit. Results Eight patients (8 eyes) were eligible for enrollment and completed the study. There was a significant decrease in central foveal thickness (P = 0.02), central subfield thickness (P = 0.03), and thickest macular cut (P = 0.01) between the enrollment visit and the final visit. There was a decrease in mean (±SD) logarithm of the minimal angle of resolution from 0.52 (±0.35) (20/66, Snellen equivalent) at the enrollment visit to 0.41 (±0.35) (20/51, Snellen equivalent) at the final visit (P = 0.08). Conclusion Topical dorzolamide-timolol may have a beneficial anatomical and functional effect in eyes with macular edema secondary to retinal vein occlusion resistant to treatment.


Journal ArticleDOI
TL;DR: In this paper, the authors established a pigmented murine RVO model that reproduced characteristic fundus appearances similar to human RVO findings and observed retinal edema in this model was observed in both optical coherence tomography and histological analysis.

Journal ArticleDOI
TL;DR: An image-guided robotic system capable of performing automated cannulation on silicone retinal vein phantoms, integrated with an optical coherence tomography probe and a camera to provide visual feedback to guide the robotic system.
Abstract: Retinal vein of the most common causes of vision loss, occurring when a blood clot or other obstruction occludes a retinal vein. A potential remedy for retinal vein occlusion is retinal vein cannulation, a surgical procedure that involves infusing the occluded vein with a fibrinolytic drug to restore blood flow through the vascular lumen. This article presents an image-guided robotic system capable of performing automated cannulation on silicone retinal vein phantoms. The system is integrated with an optical coherence tomography probe and a camera to provide visual feedback to guide the robotic system. Through automation, the developed system targets a vein phantom to within 20 μm and automatically cannulates and infuses the vascular lumen with dyed water. The system was evaluated through 30 experimental trials and shown to be capable of performing automated cannulation of retinal vein phantoms with no reported cases of failure.

Journal ArticleDOI
TL;DR: The rapid development and widespread use of fundus imaging technique, especially ultra-wide-angle fundus fluorescein angiography (UWFFA) and optical coherence tomography (OCTA) have made our observation of the retinal blood vessels of RVO more comprehensive and meticulous as mentioned in this paper.
Abstract: Retinal vein occlusion (RVO) is a retinal vascular disease that severely impairs the visual function of patients. Observing the changes of retinal blood vessels before and after treatment is of great significance for the prognostic evaluation of RVO. The rapid development and widespread use of fundus imaging technique, especially ultra-wide-angle fundus fluorescein angiography (UWFFA) and optical coherence tomography angiography (OCTA) have made our observation of the retinal blood vessels of RVO more comprehensive and meticulous. In this paper, we reviewed the latest research progress of UWFFA and OCTA in RVO.

Journal ArticleDOI
TL;DR: This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution‐NonCommercial‐ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non‐commercially.
Abstract: © 2020 Indian Journal of Ophthalmology | Published by Wolters Kluwer Medknow This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution‐NonCommercial‐ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non‐commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Journal ArticleDOI
TL;DR: In this paper, the role of wide-field fluorescein angiography (WF-FA) in the diagnosis and management of retinal vein occlusion (RVO) at a single center in Poland was evaluated.
Abstract: BACKGROUND The aim of this retrospective study was to evaluate the role of wide-field fluorescein angiography (WF-FA) in the diagnosis and management of retinal vein occlusion (RVO) at a single center in Poland. MATERIAL AND METHODS This study included 106 patients (112 eyes) diagnosed with RVO (102 eyes) or impending RVO (10 eyes) (54% women and 46% men, aged 26 to 86 years). The medical records of the participants were reviewed in search of documentation on ocular and systemic diseases. Results of FA of central and peripheral retina and optical coherence tomography (OCT) scans, which had been used to establish treatment indications, were analyzed. WF-FA was performed with Spectralis HRA+OCT or Optos Tx200. RESULTS Actual RVO was found in 102 eyes. Of those cases, 46.1% were CRVO (central retinal vein occlusion), 40.2% branch retinal vein occlusion, 11.8% small tributary vein occlusion, and 1.9% hemispheric retinal vein occlusion. Neovascularization on an optic disc, neovascularization elsewhere, and veno-venous collateral vessels were observed in 32.3%, 17.4%, and 41.2% of the eyes, respectively. Peripheral ischemic zones were present in 59.8% of the eyes, in 20.6% of which, ischemia was not observed in the posterior pole. Dye leaks limited to peripheral vessels, peripheral vascular amputations, and central macular edema in OCT were observed in 17.6%, 43.1%, and 63.7% of the eyes, respectively. Retinal laser photocoagulation was conducted on 73.5% of the eyes. CONCLUSIONS Decision-making about management of patients with RVO should be done after physical examination and analysis of central and peripheral retina FA. In 20.6% of patients, assessment of the peripheral retina resulted in a change in treatment. The first changes suggestive of progression of thrombotic disease to the ischemic form appeared on the periphery in images from WF-FA.