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.

scholarly journals Aflibercept Treatment and Regimes in Macular Edema Secondary to Central Retinal Vein Occlusion

2019 ◽  
pp. 29-32
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Vision Loss ◽  
Thrombus Formation ◽  
Treatment Options ◽  
Treatment Modalities ◽  
Multiple Treatment ◽  
Vein Occlusion ◽  
Central Retinal Vein

Central retinal vein occlusion (CRVO) is the most common vascular disease leading cause of vision loss after diabetic retinopathy (DR) and branch retinal vein occlusion (BRVO). The pathogenesis of CRVO involves a thrombus formation leading to increased retinal capillary pressure, increased vascular permeability, and possibly retinal neovascularization. Vision loss due to CRVO is commonly caused by macular edema. Multiple treatment modalities have been used to treat macular edema. Currently, the most common therapy modality used is intravitreal inhibition of vascular endothelial growth factor (VEGF). The three most widely used agents are aflibercept, bevacizumab, and ranibizumab. In addition, intraocular steroids can be used to treat macular edema. This review will briefly cover the treatment options and discuss in greater detail the efficacy and safety of aflibercept.

Intravitreal Bevacizumab Injection and Treatment Regimens in Macular Edema Due to Central Retinal Vein Occlusion

2019 ◽  
pp. 33-37
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Vision Loss ◽  
Treatment Options ◽  
Intravitreal Bevacizumab ◽  
Treatment Modalities ◽  
Vegf Inhibitors ◽  
Vein Occlusion ◽  
Central Retinal Vein

Central retinal vein occlusion (CRVO) is the second most common vascular disease leading cause of vision loss together with branch retinal vein occlusion (BRVO) after diabetic retinopathy (DR). Vision loss due to CRVO is commonly caused by macular edema and multiple treatment modalities have been used to treat macular edema. In clinical practice, VEGF inhibitors are now the first-line treatment offered to patients who have CRVO with macular edema. The two agents approved by the FDA for the treatment of macular edema are aflibercept and ranibizumab. Bevacizumab is another VEGF inhibitor that has been used off-label to treat macular edema. Several studies have demonstrated that bevacizumab is effective in improving vision and decreasing central macular thickness when used in patients with macular edema due to central retinal vein occlusions. In the current review, the treatment options will be evaluated briefly and the efficacy and safety of bevacizumab will be discussed in greater detail.

scholarly journals Surgical Treatment in Central Retinal Vein Occlusion

2019 ◽  
pp. 58-63
Keyword(s):  
Surgical Treatment ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Treatment Modalities ◽  
Surgical Approaches ◽  
Vein Occlusion ◽  
Systemic Treatments ◽  
Central Retinal Vein

Retinal vein occlusion (RVO) is the second most common vascular disease after diabetic retinopathy. Central retinal vein occlusion (CRVO) is less common than branched retinal vein occlusion. There are different aspects of the mechanisms underlying etiology and optimal treatment strategies in CRVO. There are various treatment modalities for CRVO including observation, systemic treatments, intravitreal agents, laser photocoagulation, fibrinolytic treatment, and surgical approaches. Despite most of the treatment strategies are directed at secondary complications of CRVO that affect vision including macular edema and retinal neovascularization, some treatment options also have the ability to create a bypass around the obstructed retinal vein and to decrease the raised venous hydrostatic pressure. The aim of this review is to describe the outcomes of surgical treatment modalities for CRVO.

scholarly journals Clinical profile and management of vitreous hemorrhage in tertiary eye care centre in Nepal

2020 ◽  
Vol 12 (1) ◽  
pp. 99-105
Author(s):  
Laxmi Devi Manandhar ◽  
Raba Thapa ◽  
Govinda Poudyal
Keyword(s):  
Emergency Department ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vision Loss ◽  
Vitreous Hemorrhage ◽  
Sudden Onset ◽  
Age Group ◽  
Care Centre ◽  
Vein Occlusion ◽  
Common Etiology

Introduction: Vitreous hemorrhage is one of the most common diseases presenting to emergency department and leading cause of painless vision loss. Objectives: To determine the profile of vitreous hemorrhage in patients presented to Outpatient Department (OPD) and emergency Department of Tilganga Institute of Ophthalmology (TIO). Materials and methods: This is a hospital based observational non interventional descriptive study. Total 198 patients were enrolled who visited OPD and Emergency department of TIO from August 1st 2012 to July 30th 2013. Result: Total 198 patients (201 eyes) were enrolled for the study, out of which 144 were male and 54 females. 195 were unilateral and 3 bilateral cases. Most common age group of presentation of vitreous hemorrhage was 51-60 years (24.75%). Most common presenting complaint was sudden onset of decreased vision (95%). Most common etiology of vitreous hemorrhage was branch retinal vein occlusion (22.38%). Among the total subjects, 57.7% of the patient were managed with medical therapy, 35.8% surgically and 6.47 % with combined medical and surgical treatment. Conclusion: Branch retinal vein occlusion (BRVO) is the most common cause of vitreous hemorrhage. Diabetes and hypertension are the most commonly associated systemic illnesses.

scholarly journals Recent trends in managing abnormal uterine bleeding

2021 ◽  
Vol 10 (4) ◽  
pp. 1742
Author(s):  
Shruthi Ananthula ◽  
Ushadevi Gopalan ◽  
Sivan Kumar Kumarapillai
Keyword(s):  
Surgical Treatment ◽  
Treatment Options ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Treatment Modalities ◽  
Major Surgery ◽  
High Morbidity ◽  
Management Options ◽  
Mesh Terms

Abnormal uterine bleeding is one of the most common problems among women of reproductive age. It is an important health care problem and may cause physiological as well as psycological stress impairing the quality of life. The aim of this review was to present various management options for women suffering from menorrhagia. An extensive electronic literature search was done using search engines like PubMed and Google scholar using the mesh terms/ key words like “abnormal uterine bleeding, menorrhagia, medical management, hysterectomy” to identify trials and reviews on management of abnormal uterine bleeding. Various pharmacological and surgical treatment options are available, among medical therapy Tranexamic acid being most effective. Second-generation endometrial ablation techniques are effective and safe alternatives compared to first-generation devices. Hysterectomy should be considered as a last resort in management of AUB as this major surgery is associated with high morbidity and mortality rates. Thus role of clinician is to counsel every women and provide full information regarding both medical as well as surgical treatment modalities available and facilitate them in making an appropriate choice.

scholarly journals Management of endometriosis-related infertility: Considerations and treatment options

2020 ◽  
Vol 47 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Dayong Lee ◽  
Seul Ki Kim ◽  
Jung Ryeol Lee ◽  
Byung Chul Jee
Keyword(s):  
Surgical Treatment ◽  
Ovarian Reserve ◽  
Intrauterine Insemination ◽  
Treatment Options ◽  
Oocyte Retrieval ◽  
Reproductive Age ◽  
Treatment Modalities ◽  
Inflammatory Reactions ◽  
Risk Of Cancer

Endometriosis is a common inflammatory disease in women of reproductive age and is one of the major causes of infertility. Endometriosis causes a sustained reduction of ovarian reserve through both physical mechanisms and inflammatory reactions, which result in the production of reactive oxygen species and tissue fibrosis. The severity of endometriosis is related to ovarian reserve. With regard to infertility treatment, medical therapy as a neoadjuvant or adjuvant to surgical therapy has no definite beneficial effect. Surgical treatment of endometriosis can lead to ovarian injury during the resection of endometriotic tissue, which leads to the deterioration of ovarian reserve. To overcome this disadvantage, a multistep technique has been proposed to minimize the reduction of ovarian reserve. When considering surgical treatment of endometriosis in patients experiencing infertility, it should be kept in mind that ovarian reserve can be reduced both due to endometriosis itself and by the process of removing endometriosis. In cases of mild- to moderate-stage endometriosis, intrauterine insemination with ovarian stimulation after surgical treatment may increase the likelihood of pregnancy. In cases of severe endometriosis, the characteristics of the patient should be considered in a multidisciplinary manner to determine the prioritization of treatment modalities, including surgical treatment and assisted reproduction methods such as <i>in vitro</i> fertilization. The risk of cancer, complications after pregnancy, and infection during oocyte retrieval should also be considered when making treatment decisions.

Hemodynamics Associated With Intracerebral Arteriovenous Malformations: The Effects of Treatment Modalities

Neurosurgery ◽  
2017 ◽  
Vol 83 (4) ◽  
pp. 611-621 ◽  
Author(s):  
Vernard S Fennell ◽  
Nikolay L Martirosyan ◽  
Gursant S Atwal ◽  
M Yashar S Kalani ◽  
Francisco A Ponce ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Endovascular Embolization ◽  
Treatment Modalities ◽  
Cerebral Arteriovenous Malformations ◽  
Venous Outflow ◽  
Comprehensive Literature Review ◽  
Flow Through ◽  
Changes Over Time

Abstract The understanding of the physiology of cerebral arteriovenous malformations (AVMs) continues to expand. Knowledge of the hemodynamics of blood flow associated with AVMs is also progressing as imaging and treatment modalities advance. The authors present a comprehensive literature review that reveals the physical hemodynamics of AVMs, and the effect that various treatment modalities have on AVM hemodynamics and the surrounding cortex and vasculature. The authors discuss feeding arteries, flow through the nidus, venous outflow, and the relative effects of radiosurgical monotherapy, endovascular embolization alone, and combined microsurgical treatments. The hemodynamics associated with intracranial AVMs is complex and likely changes over time with changes in the physical morphology and angioarchitecture of the lesions. Hemodynamic change may be even more of a factor as it pertains to the vast array of single and multimodal treatment options available. An understanding of AVM hemodynamics associated with differing treatment modalities can affect treatment strategies and should be considered for optimal clinical outcomes.

Nonresponsiveness, Resistance to the Treatment, Drug Switch and Combined Treatments in Macular Edema Secondary to Central Retinal Vein Occlusion

2019 ◽  
pp. 45-49
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Vegf Receptor ◽  
Combined Treatments ◽  
Vein Occlusion ◽  
Vitreoretinal Traction ◽  
Retinal Vascular Disease ◽  
Central Retinal Vein ◽  
Macular Ischemia

Retinal vein occlusion (RVO) is the second most common retinal vascular disease following diabetic retinopathy. Visual loss in central retinal vein occlusion (CRVO) may occur due to retinal ischemia, macular ischemia, macular edema, or neovascular complications. In CRVO, macular edema can develop due to increased vascular permeability due to inflammation and elevated VEGF levels, and breakdown of the blood-retina barrier. In cases with CRVO, resistance, and/or nonresponsiveness to the treatment develops in about one of three of the cases. The presence of the relative afferent pupillary defect, vitreoretinal traction, poor macular and peripheral retinal perfusion, high blood urea and creatinine levels, ineffectiveness to other cytokines and factors, delay in the initiation of the treatment, VEGF receptor up-regulation, advanced age are risk factors for non-responsiveness. Positive results on visual acuity, central macular thickness, and the number of injections can be obtained by replacing one Anti-VEGF agent with another and/or by combined treatments with steroids in the treatment of the resistant/non-responsive cases.

scholarly journals Non-Routine Therapies for the Treatment of Branched Retinal Vein Occlusion and Macular Edema

2019 ◽  
pp. 120-128
Keyword(s):  
Macular Edema ◽  
Laser Therapy ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vitreous Hemorrhage ◽  
Treatment Modalities ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Emerging Therapies ◽  
Endothelial Growth Factors

Retinal vein occlusion is the second most common retinal vascular disorder after diabetic retinopathy and is considered to be an important cause of visual loss. There are several treatment modalities for branch retinal vein occlusion and specifically for its complications, such as macular edema, vitreous hemorrhage, retinal neovascularization, and retinal detachment. These treatment modalities are anti-aggregative therapy and fibrinolysis, isovolemic hemodilution, vitrectomy with or without sheathotomy, peripheral scatter and macular grid retinal laser therapy, non-steroid agents, intravitreal steroids ( triamcinolone, and dexamethasone implants), and intravitreal anti-vascular endothelial growth factors (anti-VEGFs) (bevacizumab, ranibizumab, aflibercept). In this review, the treatment modalities other than routinely performed anti-VEGF, steroid, and laser therapy in macular edema secondary to branch retinal vein occlusion and emerging therapies will be overviewed.

scholarly journals Juvenile diabetes eye complications and treatment

2009 ◽  
Vol 66 (9) ◽  
pp. 729-732 ◽  
Author(s):  
Mirjana Dujic ◽  
Zora Ignjatovic
Keyword(s):  
Diabetic Retinopathy ◽  
Vision Loss ◽  
Disease Onset ◽  
Clinical Signs ◽  
Onset Time ◽  
Vitreous Hemorrhage ◽  
Juvenile Diabetes ◽  
Treatment Modalities ◽  
Panretinal Photocoagulation ◽  
The Mean

Background/Aim. Diabetes mellitus (DM) is a metabolic disorder characterized by hyperglycemia. The aim of this study was to explore the prognosis of patients with juvenile DM regarding diabetic eye complications, as well as the course of the diabetic eye disease related to the treatment undertaken. Methods. The study series involved 33 patients with juvenile DM during the period 1992-2007. The influence of the following factors on the course of the disease was estimated: age, the age of the disease onset, time when eye complications appeared, treatment modalities. Results. Of the total of 33 diabetics 15 patients were followed for 10 or more years and 18 from 5 to 9 years. At the time of their first visit the mean age was 23.12 ? 6.39 and the mean duration of DM was 17.42 ? 7.42 years. On their first visit, 7 eyes were without any complication. Most of the patients already developed clinical signs of proliferative diabetic retinopathy (41.39%), the signs of nonproliferative diabetic retinopathy (13.13%) and macula involvement (10.10%). Diabetic cataract was found in 8.8% as well as tractional retinal detachment. Eleven out of 66 eyes were with vitreous hemorrhage. Two patients (5.5%) suffered neovascular glaucoma. There was 1 (2.2%) patient with developed rubeosis iridis and simplex glaucoma. Panretinal photocoagulation was performed in 65% of patients, focal photocoagulation in 15%, 12% patients underwent pars plana vitrectomy and 4% had cataract surgery with intraocular lens implantation and peripheral retinal kryopexy. Conclusion. Total vision loss due to eye complications of juvenile DM may be prevented if timely diagnosed with regular check ups and early treatment.

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