scholarly journals Iatrogenic Retinal Penetration from Intravitreal Injections

2021 ◽  
pp. 248-253
Author(s):  
Kamal Kishore ◽  
Daniel S. McGowan ◽  
Kurt A. Hanebrink
Keyword(s):  
Injection Site ◽  
Case Series ◽  
Vitreous Hemorrhage ◽  
Injection Technique ◽  
Round Hole ◽  
Neovascular Amd ◽  
Vein Occlusion ◽  
Lattice Degeneration ◽  
Retinal Hole ◽  
Central Retinal Vein

We present 2 cases of iatrogenic retinal penetration from intravitreal (IVT) injections in a retrospective noncomparative case series of 2 patients. The first patient, an 81-year-old Caucasian male, developed dense vitreous hemorrhage soon after receiving an IVT bevacizumab injection for macular edema from central retinal vein occlusion. A 25-g vitrectomy 1 week later showed a retinal hole surrounded by fresh hemorrhages in the same quadrant as the IVT injection. The second patient, an 87-years-old male, developed a retinal detachment after 28 injections of anti-VEGF medications for neovascular AMD. A peripheral round hole was observed during vitrectomy without any lattice degeneration in the same quadrant as prior IVT injections. Both eyes were pseudophakic, had normal axial lengths, and received injections without measuring the injection site. Retinal penetration from IVT injections can result in serious sight-threatening complications. Measuring the injection site from the limbus should be part of safe IVT injection technique.

scholarly journals The Effect of Antivascular Endothelial Growth Factor Therapy on the Development of Neovascular Glaucoma after Central Retinal Vein Occlusion: A Retrospective Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Christina L. Ryu ◽  
Adrian Elfersy ◽  
Uday Desai ◽  
Thomas Hessburg ◽  
Paul Edwards ◽  
...  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Significant Risk ◽  
Case Series ◽  
Neovascular Glaucoma ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Central Retinal Vein

Purpose. Ischemic central retinal vein occlusion (CRVO) eyes are at high risk of developing neovascular glaucoma (NVG). Our purpose is to investigate the effect of anti-VEGF therapy for macular edema after CRVO on the development of neovascular glaucoma (NVG) in ischemic CRVO eyes.Methods. This is a retrospective case series of 44 eyes from 44 patients with CRVO treated with anti-VEGF therapy for macular edema. The primary outcome was the development of NVG.Results. Of the 44 eyes, 14 eyes had ischemic CRVO, and 30 eyes had nonischemic CRVO. Nonischemic eyes received a mean of 8.4 anti-VEGF doses, over mean follow-up of 24 months. One nonischemic eye (3.3%) developed NVD but not NVG. The 14 ischemic eyes received a mean of 5.6 anti-VEGF doses, with mean follow-up of 23 months. Of these 14 ischemic eyes, two eyes (14%) developed iris neovascularization and 3 eyes (21%) developed posterior neovascularization. Three of these 5 eyes with neovascularization progressed to NVG, at 19.7 months after symptom onset, on average.Conclusion. Anti-VEGF therapy for macular edema may delay, but does not prevent, the development of ocular NV in ischemic CRVO. Significant risk of NVG still exists for ischemic CRVO eyes.

scholarly journals MEK Inhibitor-Associated Central Retinal Vein Occlusion Associated with Hyperhomocysteinemia and MTHFR Variants

2019 ◽  
Vol 6 (3) ◽  
pp. 159-163
Author(s):  
Jasmine H. Francis ◽  
Eli L. Diamond ◽  
Ping Chi ◽  
Korey Jaben ◽  
David M. Hyman ◽  
...  
Keyword(s):  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Elevated Serum ◽  
Rare Event ◽  
Case Series ◽  
Mek Inhibitor ◽  
Cancer Center ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Central Retinal Vein

Background: Central retinal vein occlusion (CRVO) is a visually threatening event that has rarely been observed in patients taking MEK1/2 inhibitors and that may necessitate permanent discontinuation of a potentially efficacious therapy. We investigated the clinical characteristics of CRVO in patients on mitogen-activated protein kinase kinase (MEK) inhibition to better understand their predisposing factors and clinical course. Case Series: This was a single-center, retrospective cohort study (between December 2006 and September 2018). Three of 546 patients enrolled in 46 prospective trials involving treatment with MEK inhibitors at Memorial Sloan Kettering Cancer Center were identified as having CRVO. Clinical examination and course, multimodal ophthalmic imaging, and serum laboratory results (including homocysteine levels and genetic variants of methylene tetrahydrofolate reductase [MTHFR]) were reviewed for the 3 affected patients. All 3 patients with MEK inhibitor-associated CRVO had elevated serum homocysteine and gene variants of MTHFR (1 homozygous for A1298C, 1 heterozygous for A1298C, and 1 homozygous for C677T). Following intravitreous injections of anti-VEGF and discontinuation of drug, all patients regained vision to their baseline. Discussion: MEK inhibitor-associated CRVO is a rare event which can exhibit visual recovery after drug cessation and intravitreous anti-VEGF injections. In this cohort, it was associated with hyperhomocysteinemia and genetic mutations in MTHFR, suggesting a potential role for hyperhomocysteinemia screening prior to initiation of MEK inhibitor therapy.

scholarly journals Pyogenic Granuloma of the Retina: A Case Series

2018 ◽  
Vol 5 (3) ◽  
pp. 176-181
Author(s):  
Samera Ahmad ◽  
Daniel Capiz-Correa ◽  
Hans E. Grossniklaus
Keyword(s):  
Granulation Tissue ◽  
Case Series ◽  
Inflammatory Cells ◽  
Pyogenic Granuloma ◽  
Histopathologic Examination ◽  
Clinicopathologic Features ◽  
Tissue Proliferation ◽  
Vein Occlusion ◽  
Vascular Channels ◽  
Central Retinal Vein

Aim: To describe the clinicopathologic features of pyogenic granuloma (granulation tissue proliferation) extending from the retina. Methods: We describe 3 patients who underwent enucleation for endophthalmitis. The eyes were processed routinely for histopathologic examination. Results: All 3 enucleated eyes contained granulation tissue with reactive vascular channels and intervening stroma infiltrated with inflammatory cells. The vascular channels were arranged in a fan-like configuration and the tissue was classified as representing pyogenic granulomas. Conclusions: Pyogenic granulomas (granulation tissue) may emanate from the retina in cases of endophthalmitis. This is distinct from neovascularization that may occur in proliferative diabetic retinopathy, central retinal vein occlusion, or other etiologies.

Central Retinal Vein Occlusion: A Rare Ocular Complication of Inflammatory Bowel Disease—A Case Series

2019 ◽  
Vol 25 (9) ◽  
pp. e110-e111 ◽  
Author(s):  
Harry Choi ◽  
Carine Bou-Abboud Matta ◽  
Gregory Fu ◽  
Georgios Trichonas ◽  
Michael L Morgan ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Bowel Disease ◽  
Case Series ◽  
Ocular Complication ◽  
Vein Occlusion ◽  
Inflammatory Bowel ◽  
Central Retinal Vein

scholarly journals Full-Thickness Retinochoroidal Incision in the Management of Central Retinal Vein Occlusion

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
San-Ni Chen ◽  
Ya-Chi Huang
Keyword(s):  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Vitreous Hemorrhage ◽  
Retinal Hemorrhage ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Full Thickness ◽  
Ischemic Group ◽  
Vein Occlusion ◽  
Central Retinal Vein

Purpose.To evaluate the clinical outcomes in patients with central retinal vein occlusion (CRVO) treated with full-thickness retinochoroidal incisions and to compare whether there is difference in treatment response in ischemic and nonischemic CRVO.Methods.Retrospective study of patients of CRVO receiving full-thickness retinochoroidal incisions in Changhua Christian Hospital. Fluorescein angiography (FA), slit-lamp biomicroscopy, indirect funduscopy, best corrected visual acuity, and central macular thickness (CMT) measured by optical coherence tomography were performed pre- and postoperatively. Patients were divided into an ischemic and nonischemic group according to the findings of FA. Patients were followed up for at least 1 year.Results.Twenty-eight eyes (14 ischemic and 14 nonischemic CRVO) were included. Functional retinochoroidal venous anastomosis (RCVA) was achieved in 48 of the 65 retinochoroidal incisions (73.8%). Central macular thickness (CMT) and retinal hemorrhage decreased significantly after the surgery. Significant visual gain was observed postoperatively in the nonischemic group, but not in the ischemic group. Postoperative complications included vitreous hemorrhage (17.8%), neovascular glaucoma (7.1%), and preretinal fibrovasular membrane (10.7%), all of which were in the ischemic group.Conclusions.RCVA formation induced by retinochoroidal incisions could improve venous flow, and decrease CMT and retinal hemorrhage. However, only eyes with nonischemic CRVO showed visual improvement.

scholarly journals Non-Ischemic Central Retinal Vein Occlusion (CRVO) and its Management using Ayurvedic Therapies: A Case Series

2020 ◽  
Vol 12 (24) ◽  
pp. 85-95
Author(s):  
Sreekala Nelliakkattu Parameswaran ◽  
Manjusree Radhakrishnan Parappurathu ◽  
Aravind Kumar ◽  
Krishnendu Sukumaran
Keyword(s):  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Case Series ◽  
Vein Occlusion ◽  
Central Retinal Vein
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