Neuroretinal atrophy following resolution of macular oedema in retinal vein occlusion

Podkowinski, Dominika; Philip, Ana-Maria; Vogl, Wolf‐Dieter; Gamper, Jutta; Bogunović, Hrvoje; Gerendas, Bianca S.; Najeeb, Bilal Haj; Waldstein, Sebastian M.; Schmidt‐Erfurth, Ursula

doi:10.1136/bjophthalmol-2017-311614

Cited by 13 publications

(22 citation statements)

References 17 publications

(11 reference statements)

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“…; Podkowinski et al. ). Meanwhile, the anti‐VEGF monoclonal antibodies such as Ranibizumab or Bevacizumab simultaneously blocks vasoprotective and neuroprotective effect besides the therapeutic function to reduce vascular permeability and inhibit aberrant neovascularization.…”

Section: Discussionmentioning

confidence: 98%

Aqueous semaphorin 3A level correlates with retinal macular oedema and ganglion cell degeneration in patients with retinal vein occlusion

Guo

Ren

Zheng-li³

et al. 2019

Acta Ophthalmologica

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Purpose: To investigate the semophorin 3A (SEMA3A) level in aqueous humor of patients with retinal vein occlusion (RVO) and explore the correlation of SEMA3A with macular oedema and ganglion cell degeneration in RVO. Methods: This comparative study prospectively included 41 consecutive patients (41 eyes) with RVO who had intravitreal anti-VEGF injections from March 2014 to March 2015 for cystoid macular oedema (CME) or neovascular glaucoma (NVG). The patients were divided into three groups according to the fluorescein angiograghy (FFA): central retinal vein occlusion (CRVO) group (n = 15), branch retinal vein occlusion (BRVO) group (n = 15) and NVG group (secondary to CRVO, n = 11). The patients who had undergone cataract surgery (n = 16) during the same period served as controls. The SEMA3A concentration in aqueous humor collected before the initial anti-VEGF injection was determined by enzyme-linked immunosorbent assay (ELISA). Central retinal thickness (CRT), cube volume (CV) and ganglion cell-inner plexiform layer (GC-IPL) thickness was analysed by spectral-domain optical coherence tomography (SD-OCT). Results: Semaphorin 3A level in CRVO group (1.52 AE 1.23 ng/ml) and NVG group (1.67 AE 0.98 ng/ml) were significantly higher than the control group (0.66 AE 0.58 ng/ ml; both p < 0.05). Moreover, SEMA3A level in CRVO group was higher than BRVO group (1.52 AE 1.23 ng/ml versus 0.53 AE 0.37 ng/ml; p < 0.05). SEMA3A level was positively correlated with CRT and CV in both BRVO group (CRT r = 0.6535, p = 0.0082; CV r = 0.5190, p = 0.0474) and CRVO group (CRT r = 0.6270, p = 0.0124; CV r = 0.6898, p = 0.0044). In RVO patients, the GC-IPL thickness of affected eyes were significantly reduced compared with the normal follow eyes (CRVO t = 4.55, p = 0.006; BRVO t = 4.54, p = 0.004). Meanwhile, negative correlation of SEMA3A level with GC-IPL thickness was found in both BRVO group (r = À0.5906, p = 0.0205) and CRVO group (r = À0.6100, p = 0.0157). Conclusion: Semaphorin 3A level is increased in aqueous humor of RVO patients. Positive correlation of CRT as well as negative correlation of GC-IPL thickness with SEMA3A may suggest a pathological role of SEMA3A in macular oedema and ganglion cell degeneration during RVO.

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Section: Discussionmentioning

confidence: 98%

Aqueous semaphorin 3A level correlates with retinal macular oedema and ganglion cell degeneration in patients with retinal vein occlusion

Guo

Ren

Zheng-li³

et al. 2019

Acta Ophthalmologica

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“…RVO is characterized by dilatation of retinal veins with retinal and subretinal hemorrhages, as well as macular edema and/or retinal ischemia (29). Moreover, RVO results in neuroretinal atrophy (30). Photoreceptor damage can be caused by subretinal hemorrhage in the central fovea and hard exudates.…”

Section: Discussionmentioning

confidence: 99%

Assessment of cerebral low-frequency oscillations in patients with retinal vein occlusion: a preliminary functional MRI study

et al. 2019

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Background There is increasing evidence that patients with retinal vein occlusion exhibit cerebral vascular changes and are at an increased risk of stroke. However, it remains unknown whether patients with retinal vein occlusion exhibit changes in intrinsic brain activity. Purpose This study investigated intrinsic brain activity changes in patients with retinal vein occlusion by assessing the amplitude of low-frequency fluctuations. Material and Methods Forty-five patients with retinal vein occlusion (22 men, 23 women, mean age 56.55 ± 6.97 years) and 43 healthy controls (13 men, 30 women; mean age 53.53 ± 8.19 years) closely matched in age, sex, and education level underwent resting-state MRI scans. The amplitude of low-frequency fluctuation method was used to compare intrinsic brain activity between the two groups. Results Compared with healthy controls, patients with retinal vein occlusion exhibited significantly lower amplitude of low-frequency fluctuation values in the left middle occipital gyrus, right middle occipital gyrus, and right calcarine. However, patients with retinal vein occlusion showed significantly higher amplitude of low-frequency fluctuations in the bilateral cerebellum 6, right hippocampus, left insula, and left fusiform (voxel-level P < 0.01, Gaussian random field correction, cluster-level P < 0.05). Conclusion Our results demonstrated that patients with retinal vein occlusion showed abnormal spontaneous neural activities in the visual cortices, cerebellum, and Papez circuit, which might indicate impaired vision, cognition, and emotional function in patients with retinal vein occlusion. These findings offer important insights into the neural mechanism of retinal vein occlusion.

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“…This may be due to irreversible damage related to chronic oedema especially in eyes with neovascular age related macular degeneration or diabetic macular oedema. BCVA outcomes are resultant upon multiple factors that influence the function of the retinal pigment epithelium and photoreceptors . Loss of vision caused by severe macular oedema may be partially reversible depending upon the level of damage to the neural retina …”

Section: Discussionmentioning

confidence: 99%

Prospective study of aflibercept for the treatment of persistent macular oedema secondary to retinal vein occlusions in eyes not responsive to long‐term treatment with bevacizumab or ranibizumab

Spooner

Fraser‐Bell

Hong³

et al. 2019

Clinical Exper Ophthalmology

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Importance: To examine the effect of switching from intravitreal bevacizumab or ranibizumab to aflibercept in eyes with persistent macular oedema due to retinal vein occlusion (RVO). Background: We report the results of a prospective interventional study on the effect of aflibercept 2 mg in eyes with persistent macular oedema after long-term treatment with bevacizumab or ranibizumab. Design: Non-randomized, prospective clinical trial. Participants: Eighteen eyes of eighteen patients were included.Methods: Eyes with persistent macular oedema despite a minimum of four previous intravitreal bevacizumab/ranibizumab injections were recruited into this 48-week trial. Three loading doses of intravitreal aflibercept were administered every 4-weeks, thereafter every 8-weeks until week 48. Main Outcome Measures: Mean change from baseline in best corrected visual acuity (BCVA) as measured by early treatment diabetic retinopathy score (ETDRS) and central macular thickness (CMT) as measured by spectral domain optical coherence tomography (SD-OCT) at 48 weeks. Results: Patients had received a mean of 40.0 ± 17.8 bevacizumab/ranibizumab intravitreal injections prior to switching to aflibercept. The mean number of previous injections administered in the 12-months preceding entry into the study was 10.2 ± 2.4. Mean vision change at week 48 was +21.1 ± 5.1 ETDRS letters in the BRVO group and +18.8 ± 5.9 letters at in the CRVO group (P < .001 for both groups). Mean decrease in CMT was 87.6 ± 48.8 μm and 191.0 ± 128.3 μm, in the BRVO and CRVO groups, respectively (P < .001). Using linear regression

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Neuroretinal atrophy following resolution of macular oedema in retinal vein occlusion

Cited by 13 publications

References 17 publications

Aqueous semaphorin 3A level correlates with retinal macular oedema and ganglion cell degeneration in patients with retinal vein occlusion

Aqueous semaphorin 3A level correlates with retinal macular oedema and ganglion cell degeneration in patients with retinal vein occlusion

Assessment of cerebral low-frequency oscillations in patients with retinal vein occlusion: a preliminary functional MRI study

Prospective study of aflibercept for the treatment of persistent macular oedema secondary to retinal vein occlusions in eyes not responsive to long‐term treatment with bevacizumab or ranibizumab

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