The effect of posterior vitreous detachment on the prognosis of branch retinal vein occlusion

Avunduk, Avni Murat; Çetinkaya, Kubilay; Kapicioğlu, Zerrin; Kaya, Can Ayhan

doi:10.1111/j.1600-0420.1997.tb00410.x

Cited by 44 publications

(30 citation statements)

References 5 publications

(6 reference statements)

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“…Therefore treatment should start as soon as possible after the acute CRVO event [45]. Avunduk et al [[46] were able to show that total PVD has an explicit preventive effect on persistent macular edema and development of retinal neovascularization. Noma et al [44,45 ]demonstrated that pars plana vitrectomy with PVD induction significantly improves VA and CMT after 6 months.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal Functional Plasminogen Is Elevated in Central Retinal Vein Occlusion

Bertelmann

Mennel²,

Sekundo³

et al. 2013

Ophthalmic Res

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Purpose: To detect intravitreal functional plasminogen in vitreous samples of patients with recent onset of central retinal vein occlusion (CRVO) and to demonstrate significantly higher intravitreal plasminogen in CRVO patients in comparison to controls. Methods: Prospective clinical case series of 13 consecutive patients with recent onset of CRVO scheduled for core pars plana vitrectomy and 10 consecutive patients undergoing standard pars plana vitrectomy for routine macular surgery or vitreal floater removal. In all 23 cases, vitreous taps were extracted from the central vitreous body, and plasminogen was functionally determined in a new ultrasensitive p-nitroanilide reaction after activation with streptokinase (100% of normal, %N = functional plasminogen in pooled normal citrated plasma). Results: Plasminogen was detected in all analyzed samples (n = 23), and mean plasminogen was revealed to be 1.33 ± 1.73% (mean ± SD), with a range of 0.03-7.8%N. Patients with recent onset of CRVO exhibited significantly higher intravitreal plasminogen (2.19 ± 1.89%N) in comparison to controls (0.20 ± 0.21%N; p < 0.001, Mann-Whitney U test). Conclusion: Due to significantly increased intravitreal plasminogen in patients with recent onset of CRVO, intravitreally administered tissue plasminogen activator might be an option to induce posterior vitreous detachment (enzymatic vitreolysis) in CRVO patients.

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Section: Discussionmentioning

confidence: 99%

Intravitreal Functional Plasminogen Is Elevated in Central Retinal Vein Occlusion

Bertelmann

Mennel²,

Sekundo³

et al. 2013

Ophthalmic Res

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“…Five studies were identified that looked at the association of PVD with neovascularization in vein occlusions [121,122,123,124,125]. Patients included in these studies had ischemic retinal vein occlusions, were followed up for a minimum of 6 months (range 6-97), and were classified based on the presence or absence of a PVD without reference to the extent of PVD.…”

Section: Influence Of Pvd In Selected Retinal Pathologies - Meta-analmentioning

confidence: 99%

The Vitreous, the Retinal Interface in Ocular Health and Disease

2013

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The vitreous is a complex structure whose composition and appearance change with age. Anomalous adhesions between the posterior vitreous face and the retinal surface are the cause of numerous vitreoretinal complications, while the presence of an intact posterior hyaloid provides a scaffold for vascular growth and anteroposterior traction. This review summarizes what is known about the biochemistry of the vitreous, the process of posterior vitreous detachment (PVD) development, and the available clinical approaches to examining the vitreous and its interface. A pooled analysis of studies looking at the presence of a complete, partial or absent PVD in a number of macular and retinal diseases allows us to establish odds ratios for these various states. From this emerge both protective and disease-associated states in conditions such as proliferative diabetic retinopathy, macular edema, and age-related macular degeneration. With the emergence of pharmacological means to separate the posterior hyaloid, a better understanding of the possible role of the vitreous in tractional syndromes is required.

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“…An attached or partially detached PVC leads to the development and expeditious progression of BRVO [2,5,6,24]. Visual impairment is, besides other mechanisms, often attributed to a consecutive macular edema [16] or neovascularization development [2] and the adhesion status was postulated as one risk factor for the development of both complications [24,25,26]. Hence, a completely detached posterior vitreous hyaloid is beneficial for the involved BRVO patient by counteracting the traction-induced processes in the vitreomacular interface as well as by preventing neovascularization development at different sites within the eye.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, posterior vitreous cortex (PVC) adhesion was demonstrated to support the development of retinal vein occlusion [5,6]. It has furthermore an impact on CME chronicity and the rate of neovascularization development within the eye [2]. This important pathophysiological aspect is not addressed with intravitreal anti-VEGF or corticosteroid injections though.…”

Section: Introductionmentioning

confidence: 99%

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Intravitreal Functional Plasminogen in Eyes with Branch Retinal Vein Occlusion

et al. 2014

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Purpose: To evaluate whether intravitreal functional plasminogen is elevated in eyes with branch retinal vein occlusion (BRVO) and to discover whether intravitreal plasminogen activities are correlated with the extent of blood-retina barrier (BRB) breakdown. Methods: Our study is a prospective case series of 20 consecutive patients with BRVO and 10 consecutive patients serving as controls. Vitreous taps were extracted from the central vitreous body and plasminogen was functionally determined in an innovative, ultrasensitive p-nitroanilide reaction after activation with streptokinase (100% of normal, %N = functional plasminogen in pooled normal citrated plasma). Intravitreal VEGF levels were assayed to estimate BRB breakdown. Results: Intravitreal functional plasminogen was detected in all analyzed samples (n = 30) and mean (±SD) plasminogen activities were found to be 0.97 ± 1.06%N (range: 0.03-3.9%N). Patients suffering from BRVO exhibited significantly higher intravitreal plasminogen (1.35 ± 1.11%N) in comparison with controls (0.20 ± 0.21%N, p < 0.001). Intravitreal VEGF concentrations in the BRVO group (576 ± 547 pg/ml) were significantly higher than these in controls (111 ± 120 pg/ml, p = 0.003). There was a significant correlation between intravitreal functional plasminogen and intravitreal VEGF levels (r = 0.519, p = 0.003). Conclusions: Intravitreal functional plasminogen is significantly elevated in eyes suffering from BRVO and correlates with the extent of BRB breakdown. The induction of posterior vitreous detachment by using intravitreally administered recombinant tissue plasminogen activator (enzymatic vitreolysis) should be explored in further investigations.

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The effect of posterior vitreous detachment on the prognosis of branch retinal vein occlusion

Abstract: Careful vitreous examinations of all patients with branch retinal vein occlusion give us important information about the prognosis and patient management.

Cited by 44 publications

References 5 publications

Intravitreal Functional Plasminogen Is Elevated in Central Retinal Vein Occlusion

Intravitreal Functional Plasminogen Is Elevated in Central Retinal Vein Occlusion

The Vitreous, the Retinal Interface in Ocular Health and Disease

Intravitreal Functional Plasminogen in Eyes with Branch Retinal Vein Occlusion

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