scholarly journals Vitrectomy for Vitreous Hemorrhage Secondary to Branch Retinal Vein Occlusion

2020 ◽  
Author(s):  
Gengmin Tong ◽  
Qintuo Pan ◽  
Yishan Hu ◽  
Dawei Wang ◽  
Yanhua Jin
Keyword(s):  
Visual Acuity ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vitreous Hemorrhage ◽  
Foveal Thickness ◽  
Vein Occlusion ◽  
Number Of Patients ◽  
Surgical Methods ◽  
Significant Difference ◽  
Grade Iii

Abstract PurposeTo 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).MethodsWe 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. According to the intraoperative observation, we divided them into four different types: 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 applied according to the different retinal conditions.ResultsBCVA 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, and 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 Grade IIa group(p=0.046).The percentage of patients in the Grade I, Grade IIa, Grade IIb, and Grade III groups underwent further laser treatment after surgery was 0%,8.3%,16.3%, and 23.5%, respectively(p<0.05).ConclusionVitrectomy 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 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 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 The Analysis of Correlative Factors of Visual Acuity with Intravitreal Conbercept Injection in Macular Edema Associated with Branch Retinal Vein Occlusion

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Wenjuan Luo ◽  
Fengjiao Jia ◽  
Min Liu ◽  
Yunxiao Wang ◽  
Ting Zhang
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Layer Thickness ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Outer Nuclear Layer ◽  
Foveal Thickness ◽  
Photoreceptor Layer ◽  
Vein Occlusion

Purpose. To evaluate the correlative factors of best-corrected visual acuity (BCVA) with intravitreal conbercept injection in macular edema secondary to branch retinal vein occlusion (BRVO). Methods. This is a self-controlled retrospective study. 35 eyes of 35 patients with macular edema secondary to BRVO were enrolled. After an initial intravitreal injection of conbercept (0.5 mg/0.05 ml) monthly up to 3 months, a pro re nata (PRN) strategy was adopted based on the increase in central foveal thickness (CFT). Data collected at various time points include BCVA, CFT, photoreceptor layer thickness (PLT), and outer nuclear layer thickness (ONLT) on optical coherence tomography. The correlation between CFT, PLT, ONLT, and BCVA before and after injections was analyzed. Results. Compared with baseline, in months 1, 3, and 6 after injection, the improvement of BCVA was 20.63, 22.94, and 21.06 ETDRS letters, respectively (F=195.843, P<0.01), and the decrease of CFT was 217.37 μm, 224.57 μm, and 224.06 μm, respectively (F=148.522, P<0.01). The PLT in months 1, 3, and 6 after therapy has significant improvement of 11.14 μm, 13.03 μm, and 13.49 μm (F=64.116, P<0.01), while the ONLT has a significant decrease of 225.29 μm, 237.66 μm, and 239.11 μm, respectively (F=145.231, P<0.01). The changes in the treatment group were significant in different periods. The mean number of injections was 3.26 ± 0.50 from baseline to month 6. Conclusions. Intravitreal injection of conbercept provides an effective treatment for macular edema due to BRVO. With six-month treatment, there were a positive correlation between BCVA and PLT (r=0.592, P<0.001), a negative correlation between BCVA and ONLT (r=−0.480, P=0.005), and no correlation between BCVA and CFT (P=0.506).

Macular vessel reduction as predictor for recurrence of macular oedema requiring repeat intravitreal ranibizumab injection in eyes with branch retinal vein occlusion

2018 ◽  
Vol 103 (10) ◽  
pp. 1367-1372 ◽  
Author(s):  
Taiji Hasegawa ◽  
Yohei Takahashi ◽  
Ichiro Maruko ◽  
Akiko Kogure ◽  
Tomohiro Iida
Keyword(s):  
Visual Acuity ◽  
Retinal Vein Occlusion ◽  
Macular Oedema ◽  
Branch Retinal Vein Occlusion ◽  
Initial Visit ◽  
Intravitreal Ranibizumab ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Vein Occlusion ◽  
The Mean

AimTo determine whether there are factors that can predict the frequency of recurrences of macular oedema associated with branch retinal vein occlusion (BRVO).MethodsWe reviewed the medical records of 31 eyes with treatment-naïve macular oedema associated with BRVO. All eyes received an intravitreal ranibizumab (IVR) injection and were followed with a pro re nata protocol for at least 12 months. A reinjection of ranibizmab was performed when the central foveal thickness was ≥300 µm. At 1 month after IVR injection, the macular vessel reduction was calculated by comparing the vessel density in the optical coherence tomography angiography in the BRVO involved half to that in the non-involved half.ResultsThe mean visual acuity improved from 0.35±0.27 logarithm of the minimal angle of resolution (logMAR) units (20/45; Snellen) at initial visit to 0.06±0.15 logMAR units (20/23) at 12 months (p<0.0001). During 12 months, the mean number of IVR injections was 3.8±1.8. Multivariate regression analysis showed that a greater macular vessel reduction at 1 month after initial IVR injection was significantly a negative predictor of frequency of IVR injections (β=−0.5065, p=0.0082). The visual acuity and the central foveal thickness at the initial visit or at 1 month after initial IVR injection were not predictive factors for frequency of IVR injections.ConclusionsPatients with BRVO with a large macular vessel reduction at 1 month after an initial IVR injection have fewer recurrences and thus lower frequency of IVR injections during 12 months.

scholarly journals Subfoveal Choroidal Thickness and Treatment Outcomes of Intravitreal Aflibercept for Branch Retinal Vein Occlusion

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 572
Author(s):  
Yoshihito Sakanishi ◽  
Syu Morita ◽  
Keitaro Mashimo ◽  
Kazunori Tamaki ◽  
Nobuyuki Ebihara
Keyword(s):  
Treatment Outcomes ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Choroidal Thickness ◽  
Foveal Thickness ◽  
Subfoveal Choroidal Thickness ◽  
Vein Occlusion ◽  
Significant Difference ◽  
Intravitreal Aflibercept ◽  
The Mean

We aimed to investigate the relationship between subfoveal choroidal thickness (SCT) and treatment outcomes of intravitreal aflibercept (IVA) for macular edema (ME) due to branch retinal vein occlusion (BRVO). We retrospectively evaluated 46 patients with treatment-naive BRVO-ME who underwent IVA treatment between March 2016 and February 2017. There was no significant difference in visual acuity within 6 months (0.29 ± 0.20 vs. 0.27 ± 0.19, p = 0.338), the mean central foveal thickness improvement (332.0 ± 162.2 μm vs. 303.9 ± 166.6 μm, p = 0.492), and the mean number of IVA injections (1.7 ± 0.7 vs. 1.6 ± 0.7 times, p = 0.658) between the SCT thickened (n = 26 patients, 26 eyes) and SCT non-thickened groups (n = 20 patients, 20 eyes). The rate of ME recurrence was significantly lower in the SCT decreased group (6/17 eyes (35.2%) vs. 19/30 eyes (63.3%); p = 0.038). In conclusion, pretreatment choroidal thickening does not affect the therapeutic effect of IVA for BRVO, but ME recurrence was lower in cases of treatment-related choroidal thinning. Thus, changes in SCT may be a therapeutic indicator of IVA for acute BRVO.

scholarly journals Conbercept Versus Conbercept Combined with Retinal Photocoagulation for Macular Edema Secondary to Branch Retinal Vein Occlusion

2021 ◽  
Author(s):  
Gengmin Tong ◽  
Yishan Hu ◽  
Dawei Wang ◽  
Yanhua Jin
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Therapy Group ◽  
Combined Therapy ◽  
Vein Occlusion ◽  
Significant Difference ◽  
Retinal Photocoagulation

Abstract Background: To evaluate the efficacy of intravitreal injection of conbercept (IVC) with or without laser photocoagulation for recurrent macular edema secondary to branch retinal vein occlusion (BRVO). Methods: 82 patients (82 eyes) with recurrent macular edema secondary to BRVO were collected. The central macular thickness (CMT) and best corrected visual acuity (BCVA) were recorded. Results: The BCVA in both groups was significantly superior to that before treatment (P<0.05). Compared with initial values, CMT was reduced significantly in both groups (P<0.05). But at 1 month to 6 month after treatment, there are no significant difference was observed between the two groups (P>0.05). In the combined therapy group for Hemispheric Retinal Vein Occlusion, we observed a lower number of reinjections during follow-up. Conclusion: Conbercept with or without retinal photocoagulation can effectively improve the visual acuity and reduce the CMT.

scholarly journals Branch Retinal Vein Occlusion with Vitreous Hemorrhage Identified During Intraoperative Vitrectomy

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Nafila Mahida Sukmono ◽  
Ramzi Amin
Keyword(s):  
Visual Acuity ◽  
Blood Vessels ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Laser Action ◽  
Vitreous Hemorrhage ◽  
Posterior Segment ◽  
Vein Occlusion ◽  
The Right ◽  
Photocoagulation Laser

Introduction Retinal vein occlusion is the largest group of retinal blood vessels after diabetic retinopathy. Occlusion occurring in the retinal vein is divided into central retinal vein occlusion (CRVO) occlusion and branch retinal vein occlusion (BRVO) occlusion. The Beijing Eye Study, reported a higher incidence of BRVO than CRVO, where 10-year incidents for BRVO were 1.6 per 100 subjects, and CRVO was only 0.3% 100 subjects.1 To report a case of Branch Retinal Vein Occlusion with vitreous hemorrhage identified during intraoperative vitrectomy Method: A 49-year-old woman with a history of 15 years of hypertension had right eye vision complaints, increasingly blurred since last 2 months. The right eye visual acuity 2/60 cannot be corrected and left eye 6/30 cannot be corrected. The posterior segment on right eye is difficult to assess. USG B-Scan right eye found vitreous echospike appearance of vitreous bleeding. We manage with vitrectomy and during intraoperative we identified bleeding and ghost vessel in superotemporal area. Bleeding in the superotemporal quadrant is done by photocoagulation laser action. Results: First day postoperative there was increased in visual acuity to 6/60 with a posterior segment that could be assessed, obtained tortous blood vessels, slight bleeding and ghost vessel in the superotemporal area with laser injury. Conclusion: In this case report, patients with BRVO with complications of vitreous hemorrhage performed vitrectomy with additional endolaser in the ischemic area. The result of this action of visual acuity improvement in patient.

scholarly journals Intravitreal Conbercept For Branch Retinal Vein Occlusion induced Macular Edema: One Initial Injection Versus Three Monthly Injections

2020 ◽  
Author(s):  
Xi Chen ◽  
Tianming Hu ◽  
Jing Zuo ◽  
Hao Wu ◽  
Zehao Liu ◽  
...  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Treatment Needs ◽  
Foveal Thickness ◽  
Safety Issues ◽  
Central Foveal Thickness ◽  
Vein Occlusion ◽  
Initial Injection ◽  
Significant Difference

Abstract Objective To compare the efficacy of one initial intravitreal injection of conbercept (IVC) versus three monthly IVCs in patients with macular edema (ME) after branch retinal vein occlusion (BRVO). Both options were followed by a pro re nata (PRN) retreatment regimen.Methods This study retrospectively investigated and followed 49 patients with acute ME secondary to BRVO for over a year. 24 subjects received one initial injection (1+PRN group); while, 25 received three monthly injections (3+PRN group). The functional and anatomic outcomes were assessed during each follow-up.Results The general characteristics of the 49 subjects were as follows: mean [SD] age, 56.12 [12.54] years; 28 [57.1%] female; 30 [61.2%] non-ischemic form. Both groups showed a stable gain in visual acuity (VA) with similar logMAR (mean ± SD) (1+PRN group 0.308±0.431, 3+PRN group 0.345±0.366) during the first 12 months. Additionally, both groups exhibited a significant reduction in central foveal thickness (CFT) with no statistically significant difference between them (1+PRN group 220.5 μm ±219.9 μm , 3+PRN group 230.2 μm ±220 μm ). Both treatment groups had similar improvements in logMAR and anatomic outcomes over time. The stratified analysis showed that patients with the non-ischemic form and those with the ischemic form had similar improvements in VA (0.351±0.387 VS 0.289±0.417, P =0.601) during the 12 months follow-ups. The number of injections was lower in the 1+PRN group (4.0±1.7) than in the 3+PRN group (4.6±1.2) ( P =0.155). No adverse effects or unexpected safety issues were reported in either group.Conclusions Conpercept yielded stronger improvements in VA and CFT among patients with BRVO induced ME，independent of their retinal ischemia status. The results showed that the 3+PRN regimens do not lead to better functional outcomes or lower treatment needs in clinical practice as compared to the 1+PRN regimen.

Treatment Patterns and Clinical Outcomes for Branch Retinal Vein Occlusion: An 8-Year Experience at a Tertiary Eye Center

2021 ◽  
pp. 247412642097887
Author(s):  
Terry Lee ◽  
Cason B. Robbins ◽  
Akshay S. Thomas ◽  
Sharon Fekrat
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Retinal Vein Occlusion ◽  
Real World ◽  
Early Treatment ◽  
Branch Retinal Vein Occlusion ◽  
Treatment Patterns ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Treatment Naïve

Purpose: This work aims to investigate real-world treatment patterns and outcomes in eyes with branch retinal vein occlusion in the antivascular endothelial growth factor (anti-VEGF) era. Methods: A retrospective, nonrandomized, comparative study was conducted on eyes diagnosed with branch retinal vein occlusion at a single tertiary center between 2009 and 2017. Medical history, treatment patterns, and visual acuity outcomes were examined. Subanalysis was performed for eyes that met the eligibility criteria for the BRAVO (Ranibizumab for the Treatment of Macular Edema Following Branch Retinal Vein Occlusion) trial. Results: A total of 315 eyes were included, of which 244 were treatment naive. In all eyes, the most common first treatment was the following: intravitreal bevacizumab (38.4%), aflibercept (15.1%), ranibizumab (8.1%), sectoral scatter laser (6.2%), and triamcinolone (3.1%). At 1 year, treatment-naive eyes had received an average of 2.43 anti-VEGF injections. During follow-up, treatment-naive eyes gained an average of 0.21 Early Treatment Diabetic Retinopathy Study lines. Forty eyes that met BRAVO trial criteria received an average of 5.05 anti-VEGF injections in the first year and gained an average of 1.83 Early Treatment Diabetic Retinopathy Study lines. Conclusions: This real-world cohort received fewer anti-VEGF injections at year 1 and experienced less improvement in visual acuity during the course of treatment than clinical trial participants. Trial-eligible patients received more injections and had greater visual gains than those who would not have been eligible for the trial.

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