The vitreomacular interface in retinal vein occlusion

Abstract

ABSTRACT.Purpose: To evaluate the posterior vitreous adhesion status in patients with a history of central or branch retinal vein occlusion and to compare the results with the natural time-course of posterior vitreous detachment in healthy agerelated controls. Methods: A retrospective chart review in terms of the posterior vitreous adhesion status was performed in 132 patients (133 eyes) with a history of a central (CRVO) or branch (BRVO) retinal vein occlusion. All patients underwent vitrectomy. Based on the operation reports, the vitreous adhesion status was classified as attached, partially detached or completely detached. The results were compared to the natural time-course of posterior vitreous detachment development in healthy age-related controls. Results: Eighty-one eyes met the inclusion and exclusion criteria. Fifty-two eyes (64%) had a history of CRVO and 29 eyes (36%) a history of BRVO, respectively. In the CRVO group, the posterior vitreous was attached in 47 eyes (90%) and completely detached in five eyes (10%). In the BRVO group, the posterior vitreous was attached in 27 eyes (93%), partially detached in 1 eye (3%) and completely detached in another eye (3%). A subdivision into age classes and a comparison with healthy age-related controls [data by WeberKrause & Eckardt (1997) Ophthalmologe, 94,[619][620][621][622][623] showed in patients between 65 and 69 years of age an attached posterior vitreous cortex in 72% in healthy eyes, in 100% in CRVO (p = 0.109) and in 89% in BRVO (p = 0.440), in patients between 70 and 79 years of age an attached posterior vitreous cortex in 56% in healthy eyes, in 86% in CRVO (p = 0.010) and in 100% in BRVO (p = 0.038) and in patients between 80 and 89 years of age an attached posterior vitreous cortex in 43% in healthy eyes, in 100% in CRVO (p = 0.191) and in 67% in BRVO (p = 0.582) (Fisher's exact t-test). Conclusion: In patients with a history of CRVO or BRVO, the posterior vitreous cortex stays attached more frequently in all age groups in comparison with the healthy age-related controls.

Effects of Vitrectomy on Recurrent Macular Edema due to Branch Retinal Vein Occlusion after Intravitreal Injection of Bevacizumab

“…Bertelmann et al showed that the posterior vitreous cortex in patients with a history of BRVO attached more frequently to the retina, compared with healthy age-matched controls [18]. We did not detect apparent vitreomacular traction by ophthalmoscopy and OCT at the first visit in this series of patients.…”

The Vitreous, the Retinal Interface in Ocular Health and Disease

“…They found that 58.5% of patients with a vein occlusion developed CPVD by 6 months, with 69.6% having a PVD by 12 months as compared to 25% in the control group at both 6 and 12 months of follow-up. Records of patients undergoing an optic neurotomy or arteriovenous sheath separation indicated that the vast majority of patients had an intact posterior vitreous face prior to surgery (central retinal vein occlusion 56/61 patients; branch retinal vein occlusion 35/38) [127], an incidence which according to the authors is much higher than expected from historical controls obtained by ultrasonography. Imaging using spectral-domain OCT revealed a high frequency of perifoveal traction but was less frequently identified than with surgery [128].…”

Intravitreal Functional Plasminogen in Eyes with Branch Retinal Vein Occlusion

“…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].…”

“…Intravitreally applied anti-vascular endothelial growth factor (VEGF) as well as corticosteroids have recently improved the further course of the disease dramatically [3,4]. 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].…”