scholarly journals Wide-field angiography in retinal vein occlusions

2019 ◽  
Vol 5 (S1) ◽  
Author(s):  
Colin S. Tan ◽  
Kelvin Z. Li ◽  
SriniVas R. Sadda
Keyword(s):  
Disease Process ◽  
Vitreous Hemorrhage ◽  
Posterior Pole ◽  
Wide Field ◽  
Retinal Edema ◽  
Disease Response ◽  
Vein Occlusion ◽  
Iris Neovascularization ◽  
Retinal Vascular Disease ◽  
Retinal Pathologies

Abstract Background Retinal vein occlusion (RVO) is the second most common retinal vascular disease after diabetic retinopathy. It can result in significant visual loss from complications like macula edema, retinal and iris neovascularization, and vitreous hemorrhage. Recently, ultra-widefield imaging (UWF) has been developed for posterior pole visualization and has shown to be useful in the evaluation and treatment of RVO. Main text Ultra-widefield imaging (UWF) imaging allows for visualization of the retina up to an angle of 200°. This is especially important in detecting peripheral retinal pathologies, especially in retinal conditions such as RVO, where the disease process affects the peripheral as well as central retina. In particular, retinal non-perfusion in RVO is a risk factor for neovascularization. Various techniques, such as ischemic index and stereographic projection, have been described to assess areas of ischemia on UWF images. Retinal non-perfusion has an impact on disease complications, such as macular edema, and retinal and iris neovascularization. Retinal non-perfusion also has implications on disease response, including visual acuity, reduction in retinal edema and treatment burden. Conclusion Ultra-widefield imaging (UWF) imaging plays an important role in the assessment and management of RVO, especially in measuring retinal non-perfusion in the peripheries.

Surgical Treatment of Retinal Branch Venous Occlusion and Related Complications

2019 ◽  
pp. 129-133
Keyword(s):  
Surgical Treatment ◽  
Vision Loss ◽  
Treatment Options ◽  
Vitreous Hemorrhage ◽  
Venous Occlusion ◽  
Treatment Modalities ◽  
Venous Outflow ◽  
Vein Occlusion ◽  
Retinal Vascular Disease ◽  
Macular Ischemia

Branch retinal vein occlusion (BRVO) is the second most common cause of the retinal vascular disease after diabetic retinopathy. Vision loss from BRVO may be associated with multiple causes, including macular edema, macular ischemia, foveal hemorrhage, vitreous hemorrhage, epiretinal membrane, and retinal detachment. To date, no proven effective treatment has been shown in randomized studies. Several treatment modalities have been used in order to reestablish the venous outflow of the retina as well as for the treatment of complications. In this review, we aimed to discuss the surgical treatment approaches in the treatment of BRVO, in which some of these treatment options were already abandoned.

Creation of retinal vein occlusion model in cynomolgusmonkeys and determination of its pathological features

2020 ◽  
Vol 17 ◽  
Author(s):  
Satoshi Inagaki ◽  
Masamitsu Shimazawa ◽  
Wataru Otsu ◽  
Tomoaki Araki ◽  
Yosuke Numata ◽  
...  
Keyword(s):  
Growth Factors ◽  
Retinal Vein Occlusion ◽  
Vascular System ◽  
Retinal Thickness ◽  
Chronic Phase ◽  
Vascular Leakage ◽  
Foveal Avascular Zone ◽  
Retinal Edema ◽  
Vein Occlusion ◽  
Angiopoietin 2

Objective: A retinal vein occlusion (RVO) is a relatively common retinal vascular disorder especially in the elder-ly. Many experiments have been performed on patients with a RVO but performing any type of experiments and especially longitudinal experiments on humans is difficult if not impossible on ethical grounds. Therefore, we have created a retinal vein occlusion (RVO) model by laser irradiation of cynomolgus monkeysafter an intravenous injection of rose bengal. Weevaluated the pathological changes of the retina, and the effects of ranibizumab, an anti-vascular endothelial growth factor (VEGF) antibody, on the characteristics of the RVO. Methods: The integrity of the vascular system was evaluated by fluorescein angiography (FA), and the retinal thickness and volume were determined by optical coherence tomography (OCT). The cytokines and growth factors in the aqueous humor were identified by multiplex profiling. Results: Our results showed that ranibizumab decreased the degree of vascular leakage and retinal edema at 1-3 days (acute phase) and 3-7 days (subacute phase), and suppressed foveal thinning at 28-42 days (chronic phase) after the laser irradia-tion. Ranibizumab also decreased the area of the foveal avascular zone, and the area was negatively and significantly corre-lated with the thickness of the ganglion cell layer (GCL) complex. Furthermore, ranibizumab reduced the increased expres-sion of VEGF in the aqueous humour, but did not affect the expressions of interleukin-6 (IL-6), monocyte chemotactic pro-tein-1 (MCP-1), angiopoietin-1 (ANG-1), or angiopoietin-2 (ANG-2).Thesefindings suggest that ranibizumab attenuates the retinal edema and subsequent retinal atrophy in partby neutralizing VEGF. However, other cytokines and growth factors were also affected by the ranibizumab which suggests that not only VEGF but also other unidentified agents might play a role in the pathogenesis of the RVO. Conclusion: We have created a non-human primate RVO model, which resembles the clinical RVO pathology. In this model, an injection of ranibizumab leads to a reduction in the vascular leakage and the retinal thickness and volume by blockingthe expression of VEGF. Our model might be useful for investigating the pathological mechanisms of RVOs and explore new therapeutic agents for RVO.

Methylenetetrahydrofolate reductase polymorphisms as risk factors for retinal venous occlusive disease: A literature review

2021 ◽  
pp. 112067212110006
Author(s):  
Manuel Marques ◽  
Francisco Alves ◽  
Miguel Leitão ◽  
Catarina Rodrigues ◽  
Joana Tavares Ferreira
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Methylenetetrahydrofolate Reductase ◽  
Mthfr C677t ◽  
Mthfr Gene ◽  
Mthfr Polymorphisms ◽  
Vein Occlusion ◽  
C677t Mutation ◽  
Retinal Vascular Disease

The role of polymorphisms of methylenetetrahydrofolate reductase (MTHFR) gene in retinal vein occlusion (RVO) is a theme of discussion since the first reports of RVO in patients with MTHFR C677T mutation and without classic acquired risk factors for retinal vascular disease. The association between MTHFR polymorphisms and RVO has been studied over the last 20 years producing conflicting results. This review aims to summarize the literature concerning the role MTHFR polymorphisms as risk factors for RVO.

scholarly journals Feasibility of peripheral OCT imaging using a novel integrated SLO ultra-widefield imaging swept-source OCT device

2021 ◽  
Author(s):  
Simrat K. Sodhi ◽  
John Golding ◽  
Carmelina Trimboli ◽  
Netan Choudhry
Keyword(s):  
Posterior Pole ◽  
Field Of View ◽  
Retinal Diseases ◽  
Swept Source ◽  
Full Field ◽  
Swept Source Oct ◽  
Oct Imaging ◽  
Field Device ◽  
Areas Of Interest ◽  
Retinal Pathologies

Abstract Purpose To describe the feasibility of peripheral OCT imaging in retinal diseases using a novel full-field device. Methods A total of 134 consecutive eyes were referred and imaged on the Optos Silverstone swept-source OCT (SS-OCT) (Optos PLC; Dunfermline, UK). Scanning laser ophthalmoscope (SLO) images and the associated SS-OCT images were obtained in the posterior pole, mid-periphery or far periphery based on the nature of the referral and on new areas of interest observed in the optomap images at the time of imaging. Results A total of 134 eyes (96 patients) were enrolled in the study. One hundred and twenty-five eyes (91 patients) with 38 retinal pathologies were prospectively assessed and 9 eyes (5 patients) were excluded due to incomplete image acquisition. The average age of the subjects was 54 years (range 21–92 years). Thirty-nine out of 125 eyes (31%) had macular pathologies. Eighty-six out of 125 eyes (69%) had peripheral only pathologies, an area which cannot be visualized by standard OCT devices with a 50 degree field-of-view. Conclusions The ability to capture peripheral pathologies using an integrated SLO-UWF imaging with full-field swept-source provided high-grade anatomical insight that confirmed the medical and surgical management in a majority of cases. Its use in the mid- and far periphery provides a holistic clinical picture, which can potentially aid in the understanding of various retinal pathologies.

scholarly journals MR Imaging–Pathologic Correlation of Uveal Melanomas Undergoing Secondary Enucleation after Proton Beam Radiotherapy

2021 ◽  
Vol 11 (9) ◽  
pp. 4310
Author(s):  
Pietro Valerio Foti ◽  
Corrado Inì ◽  
Mario Travali ◽  
Renato Farina ◽  
Stefano Palmucci ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Proton Beam ◽  
Uveal Melanoma ◽  
Vitreous Hemorrhage ◽  
Nerve Degeneration ◽  
Proton Beam Radiotherapy ◽  
Iris Neovascularization ◽  
Weighted Sequences ◽  
Histopathologic Findings ◽  
Optic Nerve Degeneration

Background: Currently, radiotherapy represents the most widely employed therapeutic option in patients with uveal melanoma. Although the effects of proton beam radiotherapy on uveal melanoma end ocular tissues have been histologically documented, their appearance at MR imaging is still poorly understood. The purpose of our study was to elucidate the magnetic resonance (MR) semiotics of radiotherapy-induced changes to neoplastic tissues and ocular structures in patients with uveal melanoma undergoing secondary enucleation after proton beam radiotherapy. Methods: Nine patients with uveal melanoma who had undergone proton beam radiotherapy, MR imaging, and subsequent secondary enucleation were retrospectively selected. The histopathologic findings evaluated for irradiated tumors were necrosis, fibrosis, and viable tumor, while the histopathologic findings evaluated for extratumoral ocular/periocular tissues were radiation-related intraocular inflammation, vitreous hemorrhage, optic nerve degeneration, iris neovascularization, and periocular fibrotic adhesions. On MR images, the appearance of the abovementioned histologic features was assessed on conventional and diffusion-weighted sequences. Results: T2-weighted sequences performed better in detecting radiation-induced necrosis, fibrosis, optic nerve degeneration, and periocular fibrotic adhesions. T1-weighted sequences were preferable for identifying cataracts, vitreous hemorrhage, and inflammatory complications. Contrast-enhanced T1-weighted sequences were irreplaceable in assessing iris neovascularization, and in confirming inflammatory complications. Conclusions: In the light of their increasing role in the multidisciplinary management of patients with uveal melanoma, radiologists should be aware of the MR appearance of the effects of radiotherapy on neoplastic and ocular tissue, in order to improve the accuracy of follow-up MR examinations.

scholarly journals Intravitreal Anti-Vascular Endothelial Growth Factor Agents for the Treatment of Diabetic Retinopathy: A Review of the Literature

Pharmaceutics ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1137
Author(s):  
Irini Chatziralli ◽  
Anat Loewenstein
Keyword(s):  
Diabetic Retinopathy ◽  
Vitreous Hemorrhage ◽  
Fundus Photography ◽  
Panretinal Photocoagulation ◽  
Wide Field ◽  
Vascular Endothelial ◽  
Keywords Diabetic Retinopathy ◽  
Anti Vegf ◽  
The Impact

Background: Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population. The purpose of this review is to gather the existing literature regarding the use of the approved anti-vascular endothelial growth (anti-VEGF) agents in the treatment of DR. Methods: A comprehensive literature review in PubMed engine search was performed for articles written in English language up to 1 July 2021, using the keywords “diabetic retinopathy”, “ranibizumab”, “aflibercept”, and “anti-VEGF”. Emphasis was given on pivotal trials and recent robust studies. Results: Intravitreal anti-VEGF agents have been found to significantly improve visual acuity and reduce retinal thickness in patients with diabetic macular edema (DME) in a long-term follow-up ranging from 1 to 5 years and are considered the standard-of-care in such patients. Regarding DR, intravitreal anti-VEGF agents provided ≥2-step improvement in DR severity on color fundus photography in about 30–35% of patients with NPDR at baseline, in the majority of clinical trials originally designed to evaluate the efficacy of intravitreal anti-VEGF agents in patients with DME. Protocol S and CLARITY study have firstly reported that intravitreal anti-VEGF agents are non-inferior to panretinal photocoagulation (PRP) in patients with proliferative DR (PDR). However, the use of new imaging modalities, such as optical coherence tomography-angiography and wide-field fluorescein angiography, reveals conflicting results about the impact of anti-VEGF agents on the regression of retinal non-perfusion in patients with DR. Furthermore, one should consider the high “loss to follow-up” rate and its devastating consequences especially in patients with PDR, when deciding to treat the latter with intravitreal anti-VEGF agents alone compared to PRP. In patients with PDR, combination of treatment of intravitreal anti-VEGF agents and PRP has been also supported. Moreover, in the specific case of vitreous hemorrhage or tractional retinal detachment as complications of PDR, intravitreal anti-VEGF agents have been found to be beneficial as an adjunct to pars plana vitrectomy (PPV), most commonly given 3–7 days before PPV, offering reduction in the recurrence of vitreous hemorrhage. Conclusions: There is no general consensus regarding the use of intravitreal anti-VEGF agents in patients with DR. Although anti-VEGF agents are the gold standard in the treatment of DME and seem to improve DR severity, challenges in their use exist and should be taken into account in the decision of treatment, based on an individualized approach.

scholarly journals Vitrectomy for branch retinal vein occlusion with vitreous hemorrhage: proposal for a new grading system

2020 ◽  
Author(s):  
Gengmin Tong ◽  
Xuting Hu ◽  
Chenlei Zhu ◽  
Zhiqiang Gao ◽  
Xuhao Chen ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vitreous Hemorrhage ◽  
Grading System ◽  
Vein Occlusion ◽  
Number Of Patients ◽  
Surgical Methods ◽  
Significant Difference ◽  
Grade Iii

Abstract Purpose To investigate the long-term surgical outcomes after treatment with pars plana vitrectomy (PPV) combined with photocoagulation in different severities of branch retinal vein occlusion (BRVO) with vitreous hemorrhage (VH) in order to propose a new grading system. Methods We retrospectively reviewed the medical records of 117 eyes of 117 patients who underwent PPV for VH associated with BRVO and who were followed up for at least 12 months. Preoperative best-corrected visual acuity (BCVA), surgical intervention, final BCVA, and central foveal thickness (CFT) were evaluated using optical coherence tomography. We proposed a system to grade BRVO with VH from Grade I to Grade III with increasing severity: Grade I,pure persistent VH; Grade II,VH with epiretinal membrane (EM) (Grade IIa,VH with EM without macular involvement; Grade IIb,VH with EM with macular involvement); and Grade III,VH with tractive retinal detachment. Different surgical methods were appliedaccording to the different retinal conditions. Results BCVA significantly improved at final follow-up in all groups. There was no significant difference among the four groups in terms of preoperative BCVA, final BCVA,CFT,or the number of patients whose macular edema recurred after surgery (p>0.05), but there was a significant difference in vision improvement(p<0.05). Vision improvement in the Grade IIb group was significantly worse than in the Grade I group(p=0.006) and in the Grade IIa group(p=0.046). The percentage of patients in the Grade I, Grade IIa, Grade IIb, and Grade III groups needing further laser treatment after surgery was 0%, 8.3%, 16.3%, and 23.5%, respectively (p<0.05). Conclusion We proposed a new grading system for BRVO treated with PPV. Vitrectomy is a safe and effective treatment for BRVO with VH. Visual acuity improvement was significantly worse when the EM had macular involvement (Grade IIb).

scholarly journals Pathophysiological Role of VEGF on Retinal Edema and Nonperfused Areas in Mouse Eyes With Retinal Vein Occlusion

2018 ◽  
Vol 59 (11) ◽  
pp. 4701 ◽  
Author(s):  
Anri Nishinaka ◽  
Yuki Inoue ◽  
Shinichiro Fuma ◽  
Yoshifumi Hida ◽  
Shinsuke Nakamura ◽  
...  
Keyword(s):  
Retinal Vein Occlusion ◽  
Retinal Edema ◽  
Vein Occlusion ◽  
Pathophysiological Role

Research progress of UWFFA and OCTA in retinal vein occlusion: A review

2021 ◽  
Vol 31 (6) ◽  
pp. 2850-2855
Author(s):  
Weiting An ◽  
Jindong Han
Keyword(s):  
Blood Vessels ◽  
Retinal Vein Occlusion ◽  
Rapid Development ◽  
Research Progress ◽  
Fundus Fluorescein Angiography ◽  
Vein Occlusion ◽  
Fundus Imaging ◽  
Retinal Blood Vessels ◽  
Before And After ◽  
Retinal Vascular Disease

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.

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