Branch Retinal Vein Occlusion: Pathogenesis, Visual Prognosis, and Treatment Modalities

Řehák, J; Rehák, Matúš

doi:10.1080/02713680701851902

Cited by 355 publications

(284 citation statements)

References 131 publications

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“…1,2 Although the exact mechanism of ME in BRVO is not fully understood, ME is thought to be caused by the flux of fluid from the blood vessels to the tissue, because of breakdown of the blood-retinal barrier as a result of damage to the tight junctions of capillary endothelial cells, enhanced expression of inflammatory cytokines such as prostaglandins and interleukin 6, and increased secretion into the vitreous of vasopermeability factors such as vascular endothelial growth factor (VEGF) produced in the retina. [3][4][5][6][7] Several recent studies have reported that VEGF has an important role in the pathophysiology of ME by inducing blood-retinal barrier breakdown and increasing vascular permeability. [6][7][8][9] Elevated VEGF level in vitreous has been reported in patients with BRVO, and this elevation was correlated with the severity of ME and area of non-perfusion.…”

Section: Introductionmentioning

confidence: 99%

Combination therapy of intravitreal bevacizumab with single simultaneous posterior subtenon triamcinolone acetonide for macular edema due to branch retinal vein occlusion

Moon

Kim

Sagong

2016

Eye

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Purpose To evaluate efficacy and safety of combination therapy of intravitreal bevacizumab (IVB) with single simultaneous posterior subtenon triamcinolone acetonide (STA) for treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods This was a prospective, randomized, interventional comparative study conducted in 45 eyes with ME secondary to BRVO who were treated primarily with IVB 1.25 mg (23 eyes, IVB group) or combination therapy of IVB 1.25 mg with a single simultaneous STA 40 mg (18 eyes, IVB/STA group). Reinjections were performed with IVB if optical coherence tomography (OCT) showed recurrent ME associated with decreased visual acuity. The main outcome measurement was the number of additional IVB injections, and changes of best-corrected visual acuity (BCVA) and central macular thickness (CMT) during a 6-month follow-up period were compared. Results BCVA showed significant improvement in two groups at 6 months. In addition, CMT showed significant decrease in two groups at 6 months. No significant differences in the change of BCVA and CMT at 6 months after injection (P = 0.973, P = 0.639) were observed between the two groups. A statistically significant difference was found regarding the number of additional IVB injections (IVB group 0.96 ± 0.83; IVB/STA group 0.44 ± 0.70, P = 0.034).Conclusion Although combination therapy of IVB with a single simultaneous STA for treatment of ME secondary to BRVO did not affect the visual outcomes compared with IVB monotherapy, it had a benefit of reducing the number of additional IVB injections.

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Section: Introductionmentioning

confidence: 99%

Combination therapy of intravitreal bevacizumab with single simultaneous posterior subtenon triamcinolone acetonide for macular edema due to branch retinal vein occlusion

Moon

Kim

Sagong

2016

Eye

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“…With time, retinal ischemia and iris neovascularization may occur and lead to severe complications, including secondary glaucoma and blindness, in eyes with CRVO. 1 The pathogenesis of macular edema in RVO is not completely understood. However, some causative factors have been identified such as the role of hydrostatic effects from increased venous pressure, the presence of inflammatory cytokines (eg, prostaglandins and interleukin-6), and the upregulation of endothelial tight junction proteins, 2 or increased vascular endothelial growth factor (VEGF) expression.…”

Section: Introductionmentioning

confidence: 99%

Twelve-month experience with Ozurdex for the treatment of macular edema associated with retinal vein occlusion

Mayer

Wolf

Kernt

et al. 2013

Eye

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Purpose To evaluate the efficacy and safety of a dexamethasone implant (Ozurdex) alone or in combination with bevacizumab. Methods Sixty-four eyes were prospectively investigated. Group 1 (22 central retinal vein occlusion (CRVO) and 16 branch retinal vein occlusion (BRVO)) was treated with Ozurdex alone, and group 2 (14 CRVO and 12 BRVO) was treated with three consecutive bevacizumab injections followed by Ozurdex. Recurrences were treated with Ozurdex only. Patients were seen preoperatively and thereafter in monthly intervals. The primary end point was best-corrected visual acuity (BCVA) at 12 months. Results In group 1, BCVA improved by 6.6 (±1.7) letters in CRVO and 7.8 (±2.9) in BRVO patients, and in group 2 by 9.8 (±1.0) vs 9.4 ( ± 2.1) letters. A significant difference was only seen between CRVO patients in group 1 and 2 at 12 months (Po0.05). Recurrence after the first Ozurdex injection occurred after 3.8 (CRVO) and 3.5 months (BRVO) in group 1, vs 3.2 and 3.7 months in group 2. Elevated intraocular pressure (45 mm Hg) was measured in approximately 40% cataract progression requiring surgery in about 50% of eyes after three Ozurdex injections. Conclusion Combined treatment showed slightly better functional outcome for CRVO patients. Increased intraocular pressure and cataract progression was frequent and should be considered when an individual treatment is planned.

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“…A number of mechanisms leading to increased retinal venous pressure have previously been discussed [29]. These include an IOP increase [30], increased CSF pressure [31,32], and compression of the retinal vein by a distorted artery [33].…”

Section: Discussionmentioning

confidence: 99%

Retinal venous pressure measurements in patients with Flammer syndrome and metabolic syndrome

et al. 2017

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Background The purpose of this research is to analyze retinal venous pressure (RVP) of both eyes of patients who visited a Swiss ophthalmic practice and compare values among the following groups of patients with primary open-angle glaucoma (POAG), Flammer syndrome (FS), and metabolic syndrome (MetS). Methods RVP was measured in both eyes of all patients who visited a Swiss ophthalmic practice during March 2016 till November 2016, and the results were analyzed retrospectively. All measurements were performed by one physician by means of ophthalmodynamometry. Ophthalmodynamometry is done by applying an increasing pressure on the eye via a contact lens. The minimum force required to induce a venous pulsation is called ophthalmodynamometric force (ODF). The RVP is defined and calculated as the sum of ODF and intraocular pressure (IOP) [RVP = ODF + IOP]. Results Spontaneous central retinal venous pulsation was present in the majority of the patients (192 out of 357, 53.8%). Spontaneous RVP rate was significantly negatively correlated with age (r = −0.348, p < 0.001). A significantly increased RVP was noted in FS, MetS, and POAG patients, particularly those POAG patients who also suffered from FS (p < 0.005).Conclusions Although most patients had a spontaneous RVP, those with FS, POAG, and MetS had increased RVP. Measuring RVP by means of ophthalmodynamometry provides predictive information about certain ocular diseases and aids in instituting adequate preventive measures.

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Branch Retinal Vein Occlusion: Pathogenesis, Visual Prognosis, and Treatment Modalities

Cited by 355 publications

References 131 publications

Combination therapy of intravitreal bevacizumab with single simultaneous posterior subtenon triamcinolone acetonide for macular edema due to branch retinal vein occlusion

Combination therapy of intravitreal bevacizumab with single simultaneous posterior subtenon triamcinolone acetonide for macular edema due to branch retinal vein occlusion

Twelve-month experience with Ozurdex for the treatment of macular edema associated with retinal vein occlusion

Retinal venous pressure measurements in patients with Flammer syndrome and metabolic syndrome

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