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

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.

Eales Disease Debut in Childhood

Introduction: Eales disease is considered a peripheral retinal vascular disease characterized by inflammation (vasculitis), ischemia, vascular occlusion, and neovascularization. Its etiology is not yet defined, it generally affects young men in the second decade of life. Case: Male patient, 10 years old of age with a red eye with blurred right eye vision of 1 month of evolution that worsened 4 days before coming to the service, accompanied by photophobia and eye pain. Discussion: Eales disease affect to more often young males, whose main characteristic peripheral phlebitis which can cause retinal ischemia and neovascularization. Although its etiopathogenesis is unknown. Some cases in the literature that relate it to a type IV hypersensitivity reaction to M. tuberculosis’s antigens The treatment of choice was systemic and topical corticosteroids, with a very good clinical response and periodic follow-up of the patient, with warning signs.

Subthreshold Diode Micropulse Laser Combined with Intravitreal Therapy for Macular Edema—A Systematized Review and Critical Approach

Objective: intravitreal therapy for macular edema (ME) is a common clinical approach to treating most retinal vascular diseases; however, it generates high costs and requires multiple follow-up visits. Combining intravitreal anti–vascular endothelial growth factor (VEGF) or steroid therapy with subthreshold diode micropulse laser (SDM) application could potentially reduce the burden of numerous intravitreal injections. This review sought to explore whether this combination treatment is effective in the course of ME secondary to retinal vascular disease, and in particular, determine whether it is comparable or superior to intravitreal therapy alone. Materials and methods: the following terms and Boolean operators were used to search the PubMed literature database: subthreshold micropulse laser, subthreshold diode micropulse OR micropulse laser treatment AND anti-VEGF, anti-VEGF treatment, intravitreal steroids, OR combined therapy.This analysis included all studies discussing the combination of SDM and intravitreal anti-VEGF or steroid treatment. Results: the search revealed nine studies that met the inclusion criteria, including five comparing combined treatment and anti-VEGF treatment alone, four covering diabetic ME, and one covering ME secondary to branch retinal vein occlusion. All of these five studies suggested that combination therapy results in fewer intravitreal injections than anti-VEGF monotherapy with non-inferior functional and morphological outcomes. The remaining four studies report functional and morphological improvements after combined treatment; however, SDM alone was never superior to intravitreal-alone or combined treatment. There were substantial differences in treatment protocols and inclusion criteria between the studies. Conclusions: the available material was too scarce to provide a reliable assessment of the effects of combined therapy and its relation to intravitreal monotherapy in the treatment of ME secondary to retinal vascular disease. One assumption of note is that it is possible that SDM plus anti-VEGF might require fewer intravitreal injections than anti-VEGF monotherapy with equally good functional and morphological results. However, further randomized research is required to confirm this thesis.

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

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.

Effect of dexamethasone intravitreal implant on visual acuity and foveal photoreceptor integrity in macular edema secondary to retinal vascular disease

Purpose: To evaluate the effect of the dexamethasone intravitreal (DEX) implant on the external limiting membrane (ELM) and ellipsoid zone (EZ) integrity in treatment naïve patients with macular edema (ME) secondary to retinal vascular disease (RVD). Methods: Retrospective study conducted on patients with ME secondary to RVD, who underwent a DEX implant. Results: One-hundred eyes were included. Mean age was 70.3±11.1 years. Mean ELM integrity significantly improved from 1575.9±285.9 μm at baseline to 1711.7±244.0 μm at month 3, p<0.0001. Similarly, there was a significant improvement in EZ integrity from baseline to month-3 (1531.5±317.1 μm versus 1694.3±252.8 μm, respectively, p<0.0001). At month 3, mean visual acuity (VA) gain was 9.9±14.1 letters, p<0.0001. Mean central retinal thickness (CRT) significantly decreased by -193.2±185.7 μm from baseline to month-3, p<0.0001. Mean change in VA and CRT were significantly correlated with baseline ELM integrity (p=0.0065 and p=0.0046, respectively) and EZ (p=0.0300 and p=0.0035, respectively) integrity. At month-3, the proportion of eyes who had an intact ELM (mean difference 16.0%, 95% CI: 5.4% to 26.4%, p=0.0033) and EZ (mean difference 12.0%, 95% CI: 1.8% to 22.1%, p=0.0210) was significantly higher than at baseline. Conclusions: DEX implant was able to significantly improve ELM and EZ integrity in naïve patients with ME.