Changes in retinal ischaemic index correlate with recalcitrant macular oedema in retinal vein occlusion: WAVE study

Kwon, Soonil; Wykoff, Charles C.; Brown, David M.; Hemert, Jano van; Fan, Wenying; Sadda, Srinivas R

doi:10.1136/bjophthalmol-2017-311475

Cited by 24 publications

(25 citation statements)

References 26 publications

(10 reference statements)

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“…Retinal thinning due to macular ischemia could also be involved in the decrease in CRT. As previously shown, there may be a significant association between the resolution of retinal exudation and that of retinal nonperfusion 21,22 , because retinal perfusion could be the source of exudation. Inclusion of patients with severe CRVO in this study may be a reason for the smaller number of anti-VEGF injections relative to the number in other clinical trials [9][10][11][12][13][14][15] .…”

Section: Discussionmentioning

confidence: 91%

Factors associated with extremely poor visual outcomes in patients with central retinal vein occlusion

Nagasato¹,

Muraoka

Osaka

et al. 2020

Sci Rep

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Here, we examined prognostic factors for extremely poor visual outcomes in patients with central retinal vein occlusion (CRVO) in actual practices. We included 150 consecutive eyes with treatment-naïve acute CRVO from four different facilities and observed them for over 24 months. Macular edema (ME) was treated with one or three monthly anti-vascular endothelial growth factor injections (1 or 3 + pro re nata). According to the final Snellen visual acuity (VA), we divided the patients into very poor VA (< 20/200) and control (≥ 20/200) groups and examined risk factors for poor final visual outcomes. The baseline Snellen VA was hand motion to 20/13. The mean number of anti-VEGF injections for ME was 5.3 ± 3.7 during the follow-up period. In total, 49 (32.7%) patients exhibited a very poor final VA; this group comprised significantly older patients with a significantly poorer baseline VA (P < 0.01 for both) than the control group. Comorbid internal carotid artery disease and diabetic retinopathy were significantly associated with a poor final VA. In actual clinical practice, visual outcomes may be extremely poor despite ME treatment in certain patients with CRVO, with advanced age, poor baseline VA, and comorbid internal carotid artery disease and diabetic retinopathy being significant risk factors.

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Section: Discussionmentioning

confidence: 91%

Factors associated with extremely poor visual outcomes in patients with central retinal vein occlusion

Nagasato¹,

Muraoka

Osaka

et al. 2020

Sci Rep

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“…Of note, CMT and the levels of cytokines showed significant correlation with ischemia in the PMR and NPR. Kwon et al 18 also demonstrated that in patients with RVO and recurrent ME, the severity of ME was correlated only with ISI of PMR and the reduction in ME was correlated with the reduction in ISI in PMR and NPR following targeted retinal photocoagulation (TRP). Taken together, both our study and that of Kwon et al would appear to support the overall contention that ischemia closer to the macula (and not the far periphery) is most relevant to cytokine production and development of ME 19,20 .…”

Section: Discussionmentioning

confidence: 99%

Relationship between distribution and severity of non-perfusion and cytokine levels and macular thickness in branch retinal vein occlusion

Ryu

Noh

Hemert

et al. 2021

Sci Rep

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We aimed to investigate the relationship between non-perfusion on ultra-widefield angiography (UWF FA) and aqueous cytokine levels and central macular thickness (CMT) in eyes with branch retinal vein occlusion (BRVO). Thirty-five eyes with treatment-naïve BRVO were included. Non-perfusion area (NPA) for partial and complete ischemia was manually segmented and the ischemic index (ISI) for each was calculated using stereographically projected UWF FA for four different retinal zones. Partial and complete ischemia had different regional predominance. Partial ischemia was predominant in the posterior regions, while complete ischemia was predominant in the periphery. And partial ischemic area, located posterior to far periphery, showed significant correlation with central macular thickness and concentrations of angiogenic and inflammatory cytokines, while complete ischemic area showed no correlation with any of the parameters. Taken together, partial but not complete ischemia, particularly in the more posterior retina, was associated with higher cytokine levels and more severe macular edema in eyes with BRVO. These findings would help us to better understand the different clinical significance of ischemia in BRVO depending on the severity and regional distribution.

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“…51,52 Nonetheless, it may result in reduced ischemic indices in the perimacular and near-peripheral areas of the retina and a subsequent reduction in CME, indicating a need for further studies to elucidate the role and parameters of TRP in treating RVO. 43…”

Section: Clinical Utility Of Widefield Imagingmentioning

confidence: 99%

Ultra-widefield retinal imaging: an update on recent advances

2020

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The development of ultra-widefield retinal imaging has accelerated our understanding of common retinal diseases. As we continue to validate the diagnostic and prognostic significance of pathology in the retinal periphery, the ability to visualize and evaluate these features in an efficient and patient-friendly manner will become more important. Current interest in ultra-widefield imaging includes the development of potential biomarkers of disease progression and indicators of preclinical disease development. This article reviews the current ultra-widefield imaging systems and recent advances in their applications to clinical practice with a focus on diabetic retinopathy, retinal vein occlusion, uveitis, and pediatric retina.

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Changes in retinal ischaemic index correlate with recalcitrant macular oedema in retinal vein occlusion: WAVE study

Cited by 24 publications

References 26 publications

Factors associated with extremely poor visual outcomes in patients with central retinal vein occlusion

Factors associated with extremely poor visual outcomes in patients with central retinal vein occlusion

Relationship between distribution and severity of non-perfusion and cytokine levels and macular thickness in branch retinal vein occlusion

Ultra-widefield retinal imaging: an update on recent advances

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