Treatment of Retinal Vein Occlusions

Browning, David J.

doi:10.1007/978-1-4614-3439-9_13

Cited by 2 publications

(3 citation statements)

References 303 publications

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“…[ 47 ] For the vascular supply, whereas the peripapillary area has a double-layered capillary support system (RNFL and GCL) and connecting capillaries, the fovea is supplied only by the single-layered parafoveal capillary arcade. [ 48 ] Physiologically, the retina and especially the macula consume more oxygen per weight than any other tissue in the mammalian body; thus, the macula is likely susceptible to hypoxic and ischemic damage. [ 49 ] The diagnostic ability of segmented macular RNFL and GCIPL to discriminate between healthy eyes and eyes with glaucoma is high.…”

Section: Discussionmentioning

confidence: 99%

Quantitative optical coherence tomography angiography of macular vascular structure and foveal avascular zone in glaucoma

Choi¹,

et al. 2017

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ObjectiveThe study aimed to evaluate the quantitative characteristics of the macular vessel density (VD) and foveal avascular zone (FAZ) in glaucoma using optical coherence tomography angiography (OCT-A).DesignCross-sectional, age- and sex-matched case–control study.MethodsFifty-two eyes of 52 patients with primary open angle glaucoma and 52 eyes from 52 healthy participants were recruited retrospectively. OCT-A was performed on a 3 x 3-mm macular region centered on the fovea. OCT-A scans were manually graded to define the FAZ. Parafoveal VD in superficial and deep retina were analyzed in the circular- and quadrant-segmented zone. The FAZ parameters included size, perimeter, and circularity index. The regression analysis among VD and FAZ-related parameters and ocular parameters was performed, and the diagnostic ability was calculated with refractive error adjusted.ResultsFor both groups, the mean age and the sex ratio was not different between groups. With refractive error adjusted, the average macular VD was lower in glaucoma than in the control group for superficial (P = 0.013), deep (P<0.001), and the whole retina (P = 0.002). There were increased FAZ perimeter and decreased FAZ circularity index in glaucoma when compared with controls (P<0.001). In the multivariate regression models, FAZ circularity index were significantly associated with decreased peripapillary RNFL thickness (P = 0.007) and macular GCIPL thickness (P = 0.009) measured by OCT. The refractive-error adjusted area under receiver operating characteristics was highest for FAZ circularity index (0.905; 95% CI, 0.844–0.966), followed by temporal deep retinal VD (0.870; 95% CI, 0.803–0.937) and FAZ perimeter (0.858; 95% CI, 0.784–0.932).ConclusionsDecreased macular VD, increased FAZ perimeter, and decreased FAZ circularity index were observed in eyes with glaucoma using OCT-A. With refractive error adjusted, these parameters showed considerable diagnostic value for glaucoma. FAZ circularity index may be a novel biomarker representing disruption of the parafoveal capillary network in glaucoma, as supported by its association with structural parameters.

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Section: Discussionmentioning

confidence: 99%

Quantitative optical coherence tomography angiography of macular vascular structure and foveal avascular zone in glaucoma

Choi¹,

et al. 2017

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“…Follow-up would be guided by whether or not complications develop and by the need for treatments and type of therapy chosen (see below) "H" . Similarly, the follow-up in patients with BRVO would be determined by clinical findings, such as the presence or absence of macular edema or neovascularization and the need and type of treatment selected (see below) (40) .…”

Section: Accepted Manuscript 51mentioning

confidence: 99%

“…This treatment aims at reducing the viscosity of the blood and increasing its fluidity (94,102,297,309,316) . Although many of these studies suggested an improvement in visual acuity following isovolumetric hemodilution (94,102,297,309,316) due to the impracticality and complexity of this procedure, this treatment has not been adopted in clinical practice (40) .…”

Section: Isovolemic Hemodilutionmentioning

confidence: 99%

Ischemic retinal vein occlusion: characterizing the more severe spectrum of retinal vein occlusion

Khayat

Williams

Lois

2018

Survey of Ophthalmology

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Retinal vein occlusion (RVO)-including central RVO, branch RVO, and hemicentral and hemispheric RVO-is the second most common vascular cause of visual loss, surpassed only by diabetic retinopathy. The presence and extent of retinal ischemia in RVO is associated with a worse prognosis. On this basis, most previously conducted studies considered ischemic retinal vein occlusion (iRVO) and non-iRVO as separate entities based on set thresholds of existing retinal ischemia as determined by fundus fluorescein angiography. Other diagnostic technologies have been used specifically in the differentiation of ischemic central retinal vein occlusion and nonischemic central retinal vein occlusion. To date, there is no fully accepted definition for iRVO. Some clinicians and researchers may favor establishing a clear differentiation between these forms of RVO; others may prefer not to consider iRVO as a separate entity. Whatever the case, retinal ischemia in RVO confers a higher risk of visual loss and neovascular complications; thus, it should be determined as accurately as possible in patients with this disease and be considered in clinical and experimental studies. Most recently conducted clinical trials evaluating new treatments for macular edema secondary to RVO included none or only few patients with iRVO based on previous definitions (i.e., few patients with sizeable areas of retinal ischemia were recruited in these trials), and thus it is unclear whether the results observed in recruited patients could be extrapolated to those with retinal ischemia. There has been scant research aiming at developing and/or testing treatments for retinal ischemia, as well as to prevent new vessel formation as a result of RVO. We provide a detailed review of the knowledge gathered over the years on iRVO, from controversies on its definition and diagnosis to the understanding of its epidemiology, risk factors and pathogenesis, the structural and functional effects of this disease in the eye and its complications, natural history, and outcomes after treatment. In each section, the definition of iRVO used is given so, independently of whether iRVO is considered a separate clinical entity or a more severe end of the spectrum of RVO, the information will be useful to clinicians to determine patient's risk, guide therapeutic decisions, and counsel patients and for researchers to design future studies.

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Treatment of Retinal Vein Occlusions

Cited by 2 publications

References 303 publications

Quantitative optical coherence tomography angiography of macular vascular structure and foveal avascular zone in glaucoma

Quantitative optical coherence tomography angiography of macular vascular structure and foveal avascular zone in glaucoma

Ischemic retinal vein occlusion: characterizing the more severe spectrum of retinal vein occlusion

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