Correlation between macular ganglion cell-inner plexiform layer thickness and visual acuity after resolution of the macular edema secondary to central retinal vein occlusion

Retinal vein occlusion is the most common retinal vascular disease after diabetic retinopathy. An occlusion that affects the entire retinal venous system at the level of the lamina cribrosa is called central retinal vein occlusion (CRVO). One of the major complications that threaten visual acuity in CRVO patients is macular edema. Intravitreal dexamethasone implant is widely used in the treatment of macular edema. Efficacy has been shown in terms of short-term edema resolution and increased visual acuity. It seems that the effect on the macula decreases on average in the third month. It is a good option for patients who need to reduce the number of visits. There is no additional side effect except an increase in the incidence of cataracts with recurrent injections. Increasing of intraocular pressure appears to be a tolerable side effect. Their activities are reduced when they are done every six months or when the initial application period is long. Intravitreal steroid treatment is an effective alternative for macular edema secondary to CRVO.

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Central retinal vein occlusion: A patient with systemic sclerosis

Vojnosanitetski pregled ◽

10.2298/vsp141028073k ◽

2016 ◽

Vol 73 (9) ◽

pp. 868-872

Author(s):

Jelena Karadzic ◽

Aleksandra Radosavljevic ◽

Igor Kovacevic

Keyword(s):

Visual Acuity ◽

Systemic Sclerosis ◽

Macular Edema ◽

Retinal Vein Occlusion ◽

Central Retinal Vein Occlusion ◽

Case Reports ◽

Immunosuppressive Treatment ◽

Central Vein ◽

Vein Occlusion ◽

Central Retinal Vein

Introduction. Scleroderma (systemic sclerosis) is a severe chronic connective tissue disease, which results in involvement of numerous internal organs. Changes in the eye are the consequences of organ-specific manifestations of scleroderma or adverse effects of immunosuppressive treatment applied. Case report. We reported a 42-year-old woman with systemic sclerosis and acute deterioration of vision in the left eye, with visual acuity 0.9. After thorough clinical examination, including fluorescein angiography and optical coherence tomography, the diagnosis of nonischemic central retinal vein occlusion was made. Further biochemical, rheumatological and immunological investigation, apart from inactive systemic sclerosis, showed normal findings. Therefore, the cause of central retinal vein occlusion could only be attributed to the microvascular changes in systemic sclerosis. After three months, visual acuity deteriorated to 0.6 due to the development of cystoid macular edema. The patient received intravitreal injection of bevacizumab and after a single dose visual acuity improved to 0.9. After a 6- month follow-up, macular edema resolved and visual acuity stabilized. Conclusion. According to our knowledge and current data from the literature, central retinal vein occlusion is a rare vision threatening manifestation of scleroderma. There are only few published case reports on central vein occlusion in scleroderma patients. Examination of the ocular fundus is recommended for evaluation of vascular disease in patients with systemic sclerosis.

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A Rare Cause of Unilateral Central Retinal Vein Occlusion in a Young Patient: Type III Mixed Cryoglobulinemia

Case Reports in Ophthalmological Medicine ◽

10.1155/2016/1949362 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Sibel Doguizi ◽

Mehmet Ali Sekeroglu ◽

Mustafa Alpaslan Anayol ◽

Pelin Yilmazbas

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Retinal Vein Occlusion ◽

Central Retinal Vein Occlusion ◽

Clinical Laboratory ◽

Oral Prednisone ◽

Mixed Cryoglobulinemia ◽

Type Iii ◽

Vein Occlusion ◽

Central Retinal Vein

Purpose. To report a young male with unilateral central retinal vein occlusion (CRVO) associated with cryoglobulinemia.Case Presentation. A 33-year-old male without any known systemic or ocular disorder was admitted to our clinic with a complaint of visual loss for three days in his left eye. Based on the clinical, laboratory, and ophthalmological assessments, we diagnosed this case as type III mixed cryoglobulinemia with unilateral CRVO with macular edema. For treatment, two intravitreal ranibizumab injections were administered monthly and oral prednisone (64 mg/day) was begun. Subsequently, cryoglobulins became undetectable, macular edema decreased, and the visual acuity improved to 20/32 over an 8-week period. At 24 weeks, the patient’s visual acuity remained 20/32 and no recurrence was observed while the patient was still on prednisone (16 mg/day).Conclusion. Cryoglobulinemia should be considered in the differential diagnosis of the patients with CRVO.

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Transient Improvement in Visual Acuity and Macular Edema in Central Retinal Vein Occlusion Accompanied by Inflammatory Features After Pulse Steroid and Anti-inflammatory Therapy.

Retina ◽

10.1097/00006982-200306000-00040 ◽

2003 ◽

Vol 23 (3) ◽

pp. 433

Author(s):

S Shaikh ◽

M Blumenkranz

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Retinal Vein Occlusion ◽

Central Retinal Vein Occlusion ◽

Vein Occlusion ◽

Transient Improvement ◽

Anti Inflammatory ◽

Pulse Steroid ◽

Central Retinal Vein

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Branch Retinal Vein Occlusion Causes Topographic Optic Neuropathy and Retrograde Maculopathy

10.21203/rs.2.17537/v1 ◽

2019 ◽

Author(s):

Siqing Yu ◽

Mathias Abegg ◽

Xuan Liu ◽

Martin S. Zinkernagel ◽

Marion R. Munk ◽

...

Keyword(s):

Ganglion Cell ◽

Macular Edema ◽

Retinal Vein Occlusion ◽

Branch Retinal Vein Occlusion ◽

Plexiform Layer ◽

Inner Plexiform Layer ◽

Internal Reference ◽

Fiber Layer ◽

Vein Occlusion ◽

Anterograde Degeneration

Abstract Background To evaluate retinal ganglion cell (RGC) loss and axonal affection in branch retinal vein occlusion (BRVO).Methods 13 eyes of 12 non-glaucomatous BRVO patients were included. Thickness of peripapillary and macular retinal nerve fiber layer (pRNFL, mRNFL), ganglion cell-inner plexiform layer (GCIPL), inner nuclear layer, outer and total retina were measured at baseline and after a mean follow-up of 14 months. We compared the thickness between the affected and their internal reference regions. Additionally, pRNFL thickness was compared between the occluded and the healthy fellow eyes in the 11 unilateral cases.Results Significant degeneration of the pRNFL was observed in the affected sector of the BRVO eyes (P < 0.01 versus reference sector and versus fellow eye). In contrast, mRNFL and GCIPL thickness showed no difference between affected and reference regions and no correlation with pRNFL thickness. Degenerative microcystic macular edema (MME) was present in 25% of the eyes with macular edema following BRVO.Conclusion Axonal degeneration occurs in pRNFL, which suggests that anterograde degeneration is the mechanism of RGC affection in BRVO. Our results emphasized the importance of pRNFL monitoring in BRVO treatment, and considering degenerative MME in persistent edema following BRVO.

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Effect of Aflibercept on Cystoid Macular Edema Associated with Central Retinal Vein Occlusion. Results from a District Hospital in the United Kingdom

Klinische Monatsblätter für Augenheilkunde ◽

10.1055/a-0786-7872 ◽

2019 ◽

Vol 236 (04) ◽

pp. 547-550

Author(s):

Georgios Panos ◽

Vassileios Kostakis ◽

Grazyna Porter

Keyword(s):

Visual Acuity ◽

Adverse Effects ◽

Macular Edema ◽

Retinal Vein Occlusion ◽

Central Retinal Vein Occlusion ◽

Cystoid Macular Edema ◽

Vein Occlusion ◽

Intravitreal Aflibercept ◽

Central Retinal Vein

Abstract Purpose The purpose of this study was to report the efficiency and safety of intravitreal aflibercept for the treatment of cystoid macular edema (CME) secondary to central retinal vein occlusion (CRVO). Methods This is a retrospective cohort study. Ten naive eyes of ten patients with CME secondary to CRVO were included. All eyes received a loading dose of 3 monthly aflibercept injections followed by as-needed injections at monthly follow-up visits. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were evaluated at baseline and at the end of the follow-up period. Results The median follow-up period was 6 months (range: 6 – 9). The median number of injections was 4 (range: 3 – 5). Median BCVA improved from 1.05 LogMAR units (range: 0.7 – 1.6) at baseline to 0.65 (range: 0.4 – 1.6) at the end of the follow-up period (p = 0.02). Median CRT improved from 690 µm (range: 561 – 1235) at baseline to 243 µm (range: 207 – 531) at the end of the follow-up period (p = 0.002). The power of all statistical tests was greater than 0.8. No adverse effects or complications were documented. Conclusion Intravitreal aflibercept treatment for CME secondary to CRVO significantly improved both macular anatomy and visual acuity without adverse effects.

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