Branch Retinal Vein Occlusion Group Research Articles

Association of triglyceride‑glucose index in branch retinal vein occlusion.

To investigate the association between the triglyceride-glucose (TyG) index and newly diagnosed branch retinal vein occlusion (BRVO) in patients. The study included 57 individuals with BRVO and a control group comprising 50 healthy volunteers matched for age and gender. Detailed eye examinations were conducted, and various blood biochemistry and hematological parameters were recorded. The TyG index was calculated using fasting plasma glucose and triglyceride values. The mean age was 61.4 ± 9.6years for the BRVO group and 60.6 ± 10.3years for the control group. The TyG values were significantly higher in the BRVO group when compared to the control group (8.84 ± 0.41 vs. 8.52 ± 0.29, p < 0.001). Multivariate analysis revealed that the TyG index independently predicted BRVO (odds ratio = 2.58, 95% confidence interval = 1.69-3.93; p < 0.001). In receiver operating characteristics analysis, the TyG index had an area under the curve of 0.749, and a TyG index higher than 8.52 predicted BRVO with 83% sensitivity and 70% specificity. This study establishes a significant association between an elevated TyG index and BRVO. Consequently, the TyG index could serve as a valuable predictive tool for identifying individuals at risk for BRVO.

Relationship between ischemic index, leakage index, and macular edema in branch retinal vein occlusion.

To investigate the combined association of the ischemic index and leakage index with macular edema on ultra-widefield fluorescein angiography (UWFFA) in patients with branch retinal vein occlusion (BRVO). Retrospective image analysis study. The leakage index and ischemic index were calculated using Fiji after aligning early and late UWFFA images. Differences in the ischemic index, leakage index, and central macular thickness (CMT) between ischemic and non-ischemic BRVO were compared. Moreover, the association between the ischemic index, leakage index, and macular edema was analyzed. Eighty-three patients with BRVO were enrolled, including 53 non-ischemic BRVO and 30 ischemic BRVO patients. No significant differences were observed in leakage index and CMT between ischemic BRVO and non-ischemic BRVO (all P > 0.05). In all included patients, CMT correlated with the panretina and all subregion leakage indexes (all P < 0.01), but not with the ischemic index (all P > 0.05). In the ischemic BRVO group, CMT showed a correlation with the leakage index in several regions, but not with the ischemic index. After adjusting for the ischemic index and other clinical features, CMT remained significantly correlated with the leakage index in all regions. The leakage index may be a more effective biomarker for monitoring BRVO-associated macular edema compared to the ischemic index. Further follow-up studies are warranted to validate these findings.

Maximum carotid intima-media thickness and NT-pro BNP in association with retinal vein occlusion

The purpose is to clarify the relationship between patients with retinal vein occlusion (RVO), maximal intima-media complex thickness (Max IMT), and N-terminal pro-brain natriuretic peptide (NT-proBNP), which is useful in assessing atherosclerosis. This was a retrospective observation, single center study. The patients were 86 RVO patients (male: female = 43:43, mean age 63.3 years), 25 with central retinal vein occlusion (CRVO) and 61 with branch retinal vein occlusion (BRVO), classified as ≧50 years old and &lt;50 years old, Max IMT≧1.1 and less, NT-pro BNP≧55 and less. Results showed that Max IMT ≧1.1 was significantly more common in both the CRVO and BRVO groups at ≧50 years, and NT-pro BNP ≧55 was significantly more common in the CRVO group. Max IMT≧1.1 was seen in 80% of the BRVO group and in 85% of patients aged ≧50 years. Sixty-eight percent of patients in the CRVO group had Max IMT≧1.1, but none of those &lt; 50 years had Max IMT≧1.1. Forty-eight percent of RVO patients had NT-pro BNP≧55, and significantly more patients had Max IMT≧1.1 than those who did not have NT-pro BNP more than 55 (p = 0.02). Multiple regression analysis with Max IMT as the dependent variable showed that age and NT-pro BNP were significantly associated with RVO (p = 0.015, 0.022). RVO patients were more likely to have a Max IMT≧1.1, which was associated with atherosclerosis. Max IMT and NT-pro BNP were also associated with RVO patients, so NT-pro BNP may be a marker of RVO.

Non-perfusion severity correlates with central macular thickness and microvascular impairment in branch retinal vein occlusions.

To study peripheral capillary non-perfusion (PCN-P) in branch retinal vein occlusion (BRVO) by means of ultra wide-field fluorescein angiography (UWFFA), and to correlate its extent and severity with optical coherence tomography (OCT) and OCT-angiography (OCTA) parameters and best corrected visual acuity (BCVA). Prospective case series with 2 years of planned follow-up. We recruited patients from June 2019 to December 2019. Ophthalmologic examination included BCVA, UWFFA, OCT and OCTA. Partial (p) and complete (c) ischemic index (ISI) were evaluated on UWFFA images. Vessel density (VD) in both the macular region and the optic nerve head (ONH) was calculated. Twelve BRVO subjects and 12 healthy controls were recruited. Mean age was 63.8 ± 8.74 years. Mean BCVA improved from 0.43 ± 0.25 logMAR to 0.15 ± 0.18 after two years (p < 0.01), while mean central macular thickness (CMT) decreased from 463.83 ± 200.85 µm to 353.17 ± 108.85 µm (p > 0.05). Mean cISI, pISI and total ISI were 25.2 ± 13.0%, 6.3 ± 5.0% and 31.5 ± 12.0%, respectively. Except for VDs of the superficial capillary plexus and choriocapillaris in the macular region, all VDs were lower in the BRVO group (p < 0.01). cISI and tISI negatively correlated with mDCP (p < 0.01), whereas only pISI correlated with CMT at baseline (p < 0.05). Additionally, cISI also negatively correlated with VD at the ONH (p < 0.05). The amount of complete and partial ischemia may have different implications in BRVO, with the former being more associated with microvascular impairment and the latter with macular edema.

Long-term real-world outcomes in retinal vein occlusions: How close are we to the trials?

To assess and analyze the visual outcomes of patients with retinal vein occlusions in a real-world setting with a long-term follow-up of more than 5 years. Retrospective analysis of 56 patients having retinal vein occlusions from a tertiary eye center, with a mean follow-up of 7 years was performed. Primary outcome measures were mean change in best-corrected visual acuity (BCVA) from baseline at 6 months, 1 year, 2 years, 3 years, and final visit (≥5 years), proportion of patients having BCVA better than 20/40 and worse than 20/200, and mean number of injections. Secondary outcome measures were change in central macular thickness (CMT), development of subsequent retinal vein occlusion (RVO) in same eye or the other eye, and development of neovascular complications. The mean change in letter score was + 11.84 in branch RVO (BRVO), +7.14 in non-ischemic central RVO (CRVO), and -9.5 in ischemic CRVO at 1 year, which changed to + 8.57, -5 and - 24, respectively, at the end of follow-up. CMT had improved from 506 ± 98.8 μm, 576.44 ± 149 μm, and 618 ± 178.27 μm, respectively, at baseline to 267 ± 94 μm, 345.20 ± 122.61 μm, and 265.50 ± 107.75 μm, respectively, in BRVO, non-ischemic, and ischemic hemi RVO (HRVO)/CRVO groups. The total mean number of injections given in BRVO, non-ischemic CRVO, and ischemic CRVO groups were 4.6, 6.6, and 4.1, respectively. None of the patients with BRVO developed neovascular glaucoma (NVG). Non-ischemic to ischemic HRVO/CRVO conversion was noted in 4/11 eyes at a mean duration of 12.6 months. NVG was noted in 7/9 eyes (77.8%) in initial ischemic CRVO/HRVO group and 3/4 (75%) converted eyes. Patients with BRVO have good visual outcomes with anti-VEGF, while in CRVO results may vary considerably owing to patient compliance and treatment burden on long-term follow-up in a real-world setting.

Elevated Neutrophil Counts, Triglycerides, Monocyte/High-Density Lipoprotein Ratios, and Lower High-Density Lipoprotein in Patients with Retinal Vein Occlusion

Introduction: The aim of the study was to evaluate associations of peripheral blood immune cells and blood lipid profile levels with retinal vein occlusion (RVO). Methods: This retrospective study included 127 patients with RVO and 108 controls. Patients with RVO were divided into branch RVO (BRVO), central RVO (CRVO), ischemic RVO, or nonischemic RVO groups. Medical records were collected and analyzed. Results: The RVO group had higher mean neutrophil, triglyceride (TG), and monocyte/high-density lipoprotein (HDL) ratio (MHR) levels and lower HDL levels (p = 0.037, p < 0.001, p = 0.004, and p = 0.002, respectively). TG and MHR levels were significantly higher in the BRVO and CRVO groups compared with the control group (p < 0.001 and p = 0.016, respectively), but there was no difference in BRVO and CRVO group (p = 0.972 and p = 0.916, respectively). Mean HDL levels were significantly lower in the BRVO and CRVO groups than in the control group (p = 0.005), but the difference between the BRVO group and CRVO group was not significant (p = 0.290). Neutrophils, TG, and MHR were independent risk factors for RVO. HDL was an independent protective factor for RVO. Age was an independent risk factor for ischemic RVO. Conclusions: Lower HDL, and higher neutrophil, TG, and MHR levels are associated with RVO. Age is an independent risk factor for ischemic RVO.

Comparison of anti-VEGF results between non-ischemic branch retinal vein occlusion and ischemic branch retinal vein occlusion with early sector panretinal photocoagulation

To compare the need for anti-vascular endothelial growth factor (VEGF) in treating macular edema (ME) in patients with non-ischemic branch retinal vein occlusion (BRVO) and patients with ischemic BRVO with early peripheral photocoagulation. Patients with BRVO with ME were included in the retrospective study. The patients were divided into two groups according to peripheral ischemic status: a non-ischemic BRVO group and an ischemic BRVO group. All patients received three initial monthly 0.50mg ranibizumab injections followed by a pro re nata (PRN) regimen. In the ischemic BRVO group, early peripheral laser photocoagulation was applied in the area of capillary nonperfusion as defined by fluorescein angiography. The mean change in central macular thickness (CMT), best-corrected visual acuity (BCVA), and number of injections were evaluated. Fifty-seven eyes of 57 patients were included in the study (32 nonischemic BRVO; 25 ischemic BRVO). Mean follow-up was 20.0 (SD,4.9) months. The mean number of injections from baseline to final visit was 5.3 (SD 3.4) and 4.6 (SD 2.6) for the nonischemic BRVO group and ischemic BRVO group, respectively. This difference was not statistically significant (P=0.48). There was no significant difference in CMT and BCVA between groups. No difference in the need for anti-VEGF therapy was observed between patients with non-ischemic BRVO and patients with ischemic BRVO with early laser photocoagulation.

Effect of Conbercept Treatment on Macular Edema and Microvascular Structure in Eyes with Retinal Vein Occlusions.

ObjectiveTo evaluate the efficacy on best corrected visual acuity (BCVA) and microvascular structure changes of conbercept intravitreal injection for the treatment of macular edema (ME) secondary to different types of retinal vein occlusion (RVO) and to explore the baseline OCTA parameters which were related to the change of BCVA and CRT after the intravitreal conbercept injection to RVO.MethodsA retrospective observational study was conducted involving 67 eyes from 67 patients who were diagnosed with ME secondary to RVO between April 2019 to December 2020. The subjects were divided into branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO) according to the involved vessel, subsequently the subjects received intravitreal conbercept treatment. The BCVA and fundus microstructure were measured to identify predictors of effective outcomes.ResultsBCVA, central retinal thickness (CRT), fovea avascular zone (FAZ), and foveal vascular density (FVD) in superficial capillary plexus (SCP) were significantly changed from baseline to 6-month follow-up in both CRVO and BRVO. In the BRVO group, age and baseline BCVA were correlated with changes of BCVA, while the baseline CRT, FVD in the DCP, and parafovea vascular density (PFVD) in DCP were associated with changes of CRT (P<0.05). In the CRVO group, the baseline BCVA was correlated with changes of BCVA, while age, gender, baseline CRT, FVD in DCP, and PFVD in DCP were associated with changes of CRT (P<0.05). There were no serious adverse events (SAEs) related to the drug or the injection procedure.ConclusionIntravitreal injections of conbercept can improve BCVA and CRT and change the FVD in SCP effectively both in BRVO and CRVO groups. In addition, the baseline FVD and PFVD in the DCP were related to the change of CRT after intravitreal conbercept treatment.

Time course of changes in vision-related quality of life following intravitreal ranibizumab treatment for branch retinal vein occlusion

To evaluate the vision-related quality of life (VR-QOL) treated by intravitreal ranibizumab (IVR) in patients with branch retinal vein occlusion (BRVO) and to assess subscale items of the VR-QOL. This was prospective, multicenter, open-label, observational study including 38 patients with unilateral BRVO who underwent IVR treatment and 28 age-matched healthy subjects. VR-QOL using the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) and best-corrected visual acuity (BCVA) were examined before and at 3, 6, and 12 months after treatment. The VFQ-25 composite score and BCVA significantly improved from 3 to 12 months after IVR treatment (P < 0.05), such that there was no significant difference between the BRVO and control groups at 12 months. All subscales of the VFQ-25, except “general health”, significantly improved after treatment, while “near vision” and “mental health” were worse than those in healthy subjects (P < 0.05). Patients with superior BRVO had a lower “near vision” score than healthy subjects after treatment (P < 0.05). BCVA in the treated eye and fellow eye had no significant relationship with the VFQ-25 composite score before and after treatment. The VR-QOL of patients with BRVO improved with IVR treatment and was comparable to that of healthy subjects after 12 months. Superior BRVO particularly affected near vision for a low level.

Role of Advanced Glycation End Products in Assessment of Diabetes Mellitus as a Risk Factor for Retinal Vein Occlusion

Aim: In this study, we aimed to assess the correlation between diabetes mellitus (DM) and the retinal vein occlusion (RVO) based on skin autofluorescence (SAF) measurement, which reflects the accumulation of advanced glycation end products (AGE) in patients who have undergone an episode of central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO). Material and methods: In total, 23 patients (16 males, 7 females) with RVO were included in this study. Among these 23 participants, 12 (52%) had been diagnosed with CRVO and 11 (48%) with BRVO. The control group consisted of 14 healthy volunteers (11 females, 3 males). To calculate the risk of cardiovascular diseases (CVD) and DM, we conducted SAF examinations. We compared the SAF levels in three groups of patients: (1) with CRVO, (2) with BRVO, and (3) the control group. Basic demographic and clinical information and detailed history of the concurrent diagnoses of systemic diseases, such as systemic hypertension (HTN), DM, hyperlipidemia (HL), and heart diseases, were obtained. Results: In total, 10 (43.5%) patients were diagnosed with DM, 6 (55%) in the BRVO group and 4 (33%) in the CRVO group. The mean SAF value was significantly higher in the BRVO group than in the control group (2.64 a.u. and 2.35 a.u., respectively) (p = 0.023). More patients with risk of DM were identified in the CRVO group than in the BRVO group (p = 0.024). Conclusions: The advanced glycation end products (AGE) in the skin autofluorescence (SAF) is a viable method of evaluating the risk of DM in patients with RVO. We confirmed a correlation between RVO and DM, which was significantly pronounced in the CRVO form, although further carefully devised studies on the relationship between RVO and DM with a larger number of responders should be conducted in the future.

Novel area-based optic nerve head parameter to distinguish glaucoma from non-glaucomatous retinal nerve fiber layer defect in branch retinal vein occlusion.

The purpose of this study was to assess the diagnostic ability of the new area-based parameter retinal nerve fiber layer to disc ratio (RDR) for discriminating between glaucoma and non-glaucomatous retinal nerve fiber layer defects (RNFLDs). This retrospective cross-sectional study included 42 branch retinal vein occlusion (BRVO) eyes with RNFLD, 42 open-angle glaucoma (OAG) eyes, and 42 healthy control eyes that were matched with optic disc size. The RDR, peripapillary retinal nerve fiber layer thickness (pRNFLT), Bruch's membrane opening-minimum rim width (BMO-MRW), and Bruch's membrane opening-minimum rim area (BMO-MRA) were analyzed. The areas under the receiver operating characteristic curves (AUCs) were calculated for each parameter. The OAG and BRVO groups had similar global pRNFLT (87.57 ± 7.07µm and 89.71 ± 12.21µm, respectively), but these were thinner than those of the healthy group (102.71 ± 8.95µm, p < 0.001 and p < 0.001, respectively). RDR was lowest in the BRVO group (0.755 ± 0.121, p < 0.001) and highest in the OAG group (1.111 ± 0.145, p < 0.001). Global BMO-MRW was significantly lower in the OAG group (194.36 ± 23.09µm) than in the BRVO (269.69 ± 42.77µm, p < 0.001) and healthy (273.48 ± 30.92µm, p < 0.001) groups. Total BMO-MRA of the OAG group (0.88 ± 0.12 mm2) was significantly lower than that of the BRVO (1.32 ± 0.19 mm2, p < 0.001) and healthy (1.30 ± 0.21 mm2, p < 0.001) groups. AUC for discriminating between the OAG and BRVO was 0.986 for total BMO-MRA and 0.970 for RDR (p = 0.192). In clinical practice, RDR may perform well as a parameter to distinguish between glaucoma and non-glaucomatous RNFLD.

Significant elevation of aqueous endothelin-1 in central retinal vein occlusion.

PurposeTo investigate aqueous humor concentrations of endothelin-1 (ET-1) in patients with central retinal vein occlusion (CRVO) compared with patients with branch retinal vein occlusion (BRVO) and a normal control group.MethodsA total 80 subjects were included in this prospective study, including 15 patients with CRVO, 20 patients with BRVO, and 45 patients who underwent cataract surgery and had no concomitant ocular disease. Aqueous humor levels of ET-1 were obtained before intravitreal bevacizumab injection (IVB) and after 1 month.ResultsAt baseline, the mean aqueous ET-1 level was 12.7±3.6 pg/mL in the CRVO group, 8.0±2.3 pg/mL in the BRVO group, and 2.0±0.9 pg/mL in the control group (P<0.001). After IVB, the mean aqueous level of ET-1 was 3.4±1.9 pg/mL (0.5–6.9 pg/mL) in the CRVO group and 1.8±1.0 pg/mL (0.3–3.2 pg/mL) in the BRVO group (P = 0.008). The mean aqueous ET-1 level was significantly reduced in both the patients with CRVO and those with BRVO (P<0.001).ConclusionThe mean aqueous humor ET-1 level was significant higher in the patients with CRVO than those with BRVO and in the control group. After IVB, the mean level was significantly reduced in both the patients with CRVO and those with BRVO.

Impact of serous macular detachment on visual recovery in retinal vein occlusion treatment.

The aim of this study was to evaluate the effect of serous macular detachment observed during retinal vein occlusion on treatment results. A total of 117 eyes from 115 patients who had been treated with intravitreal injections for macular edema secondary to retinal vein occlusion were retrospectively reviewed. Visual acuity, optical coherence tomography, and fundus fluorescein angiography findings were evaluated according to the status of serous macular detachment. In the branch retinal vein occlusion group, a statistically significant increase was detected in the mean visual acuity compared to the baseline value at each visit in the absence of serous macular detachment, whereas the increase in the mean visual acuity was significant only at the 3- and 6-month visits in the presence of serous macular detachment. In the central retinal vein occlusion group, there was an increase in the mean visual acuity compared to the baseline value at every visit in the absence of serous macular detachment, whereas the mean visual acuity decreased compared to the baseline value at every visit except at the 3-month visit in the presence of serous macular detachment. The ellipsoid zone defect was more prominent in the presence of serous macular detachment in eyes with branch retinal vein occlusion, whereas there was no significant difference in the ellipsoid zone in the absence or presence of serous macular detachment in eyes with central retinal vein occlusion. In the group with macular edema due to retinal vein occlusion, the initial mean visual acuity increase observed in the first year was maintained in cases without serous macular detachment but not in those with serous macular detachment. Serous macular detachment could be a negative factor in eyes with retinal vein occlusion.

Efficacy of dexamethasone implant in the treatment of macular edema due to different etiologies

Purpose: The aim of this study was to evaluate the effectiveness of intravitreal DEX implant injection in the treatment of macular edema due to four different etiologies.Materials and Methods: This is a retrospective and case control study. A total of 177 patients who underwent intravitreal DEX implant between 2014 and 2018 for four different etiologies, which are diabetic retinopathy (DR), branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO) and posterior uveitis (PU), were included in the study. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were evaluated in pre-injection, 1st, 3rd, and 6th months post-injection.Results: Eighty-one patients (45.8%) had DR, 44 (24.9%) had BRVO, 35 (19.8%) had CRVO, and 17 (9.6%) had PU. There was a statistically significant difference in BCVA in the DR, BRVO and PU groups after the injection, but no significant difference was observed in the CRVO group. It is observed that there was a statistically significant decrease in CMT in all groups after the injection. The change in CMT in the 1st month was 153.4 ± 137 µm in the DR group, 161.1 ± 151 µm in the BRVO, 270.5 ± 189 µm in the CRVO and 142.2 ± 174 µm in the PU group.Conclusion: The intravitreal DEX implant reduces the CMT in patients with macular edema secondary to various etiologies and improves BCVA in patients with macular edema secondary to various etiologies except for patients with CRVO.

Focal lamina cribrosa defects and significant peripapillary choroidal thinning in patients with unilateral branch retinal vein occlusion.

To investigate the prevalence of focal lamina cribrosa (LC) defects in patients with unilateral branch retinal vein occlusion (BRVO) and to compare ocular characteristics between eyes with and without focal LC defect and those eyes with normal-tension glaucoma (NTG). This retrospective, cross-sectional study included 121 patients. Thirty-nine patients had unilateral BRVO (BRVO group), 36 patients had NTG (NTG group), and 36 patients had vitreous floaters, but no other ocular diseases (control group). In addition to baseline characteristics such as age, sex, refractive errors, the ocular characteristics such as peripapillary choroidal thickness (PCT), retinal nerve fiber layer thickness, and subfoveal choroidal thickness were retrospectively analyzed. Focal LC defects were detected in 20 eyes of 14 patients (38.9%) in the BRVO group, 24 eyes of 15 patients (41.7%) in the NTG group, and none in the control group (P<0.001). In the BRVO-affected eyes, the mean PCT was 102.7±31.1 μm in the eyes with focal LC defects, and 163.1±70.1 μm in the eyes without LC defects (P = 0.009). In the BRVO-affected eyes, the mean PCT was 102.7±31.1 μm in the eyes with focal LC defects, and 163.1±70.1 μm in the eyes without LC defects (P = 0.009). In the NTG group, the mean PCT was 133.1±48.9 μm in the eyes with focal LC defects and 170.8±81.9 μm in those without (P = 0.042). The other baseline and ocular characteristics were not significantly different between the eyes with and without focal LC defects in both the BRVO group and the NTG group. About 40% of the patients with unilateral BRVO had focal LC defect in the BRVO-affected eyes and unaffected fellow eyes, similar prevalence to the patients with NTG. The mean PCT was significantly thinner in the eyes with focal LC defect than those without in the patients with BRVO and those with NTG, suggesting possible pathophysiologic correlation between these two diseases.

BEVACIZUMAB FOR RETINAL VEIN OCCLUSION

Introduction: Central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) caused sudden visual decrease that most often treatable. This paper aims to describe clinical characteristic and outcome using bevacizumab for macular edema caused by retinal vein occlusion in real-life practice.&#x0D; Methods: This retrospective study included 91 treatment-naïve eyes with macular edema due to CRVO (55 eyes) and BRVO (36 eyes), who were treated with intravitreal bevacizumab (IVB) in pro re nata (PRN) regimen. Best corrected visual acuity (BCVA) and central macular thickness (CMT) before and after treatment were evaluated.&#x0D; Result: The mean age of patients was 60.3 + 11.2 years for CRVO and 55.7 + 8.2 years for BRVO. The mean baseline BCVA in the CRVO group was 1.41 + 0.55 logMAR. There was statistically significant improvement in BCVA after intravitreal bevacizumab compared to baseline (p &lt; 0.001) in CRVO and BRVO group. Twenty six (47.3%) eyes with CRVO had BCVA &gt; 1.0 logMAR (Snellen 20/200) at the last follow-up. In the BRVO group, the mean baseline BCVA was 0.93 + 0.48 logMAR. At the end of the follow up, 19 eyes (52.8%) with BRVO had BCVA &gt; 0.3 logMAR (Snellen 20/40). There was also statistically significant improvement in CMT between all time points and baseline (p &lt; 0.001) in both groups. At the end of the follow up, 26 (47.3%) eyes with CRVO and 25 eyes (69.4%) in BRVO group presented resolution of macular edema (CMT &lt; 300).&#x0D; Conclusion: Intravitreal bevacizumab resulted in significant anatomical and functional improvement in macular edema associated with CRVO and BRVO, although outcome in CRVO group was sub-optimal.

Increased cardio-ankle vascular index values in patients with acute branch retinal vein occlusion.

Purpose:Patients with retinal vein occlusions (RVOs) are at increased risk of cardiovascular disease. Arterial stiffness is an independent risk factor for cardiovascular events. Our aim is to evaluate the arterial stiffness in patients with acute branch retinal vein occlusion (BRVO) by using cardio-ankle vascular index (CAVI).Methods:This prospective study included 42 patients (18 male, mean age 57.5 ± 11.3) with acute BRVO and a matched control group (by age, sex, and presence of hypertension) with 70 (26 male, mean age 54.4 ± 9.4) patients. All patients and control subjects underwent complete ocular examination and CAVI measurement. BRVO was diagnosed based on clinical examination.Results:There were no significant differences between baseline clinical and demographic characteristics, echocardiographic measurements of left ventricular ejection fraction, systolic and diastolic blood pressure, and body mass index of the BRVO and control group. Both right and left CAVI values were found significantly higher in BRVO group (7.94 ± 1.53 vs 7.28 ± 1.25, P < 0.05 and 8.06 ± 1.41 vs 7.30 ± 1.26, P < 0.05, respectively). There were no significant difference in right and left ankle-brachial index values between the groups (1.05 ± 0.10 vs 1.06 ± 0.08, P = 0.46 and 1.04 ± 0.12 vs 1.05 ± 0.08, P = 0.46, respectively).Conclusion:Arterial stiffness is an important mediator of cardiovascular diseases. We found that CAVI which is a novel marker of the arterial stiffness is increased in patients with acute BRVO compared to controls.

The comparison of the relationships about the presence of branch retinal vein occlusion and endothelial functions between diabetic and non-diabetic patients.

The aim of this study was to investigate the endothelial functions in both patients with diabetics and non-diabetics with branch retinal vein occlusion by using pulse wave analysis and flow-mediated dilatation methods. This cross-sectional study included a total of 136 participants (47 diabetic patients with branch retinal vein occlusion, 43 non-diabetic patients with branch retinal vein occlusion, and 46 otherwise healthy subjects). Evaluation of endothelial functions was performed by flow-mediated dilatation and pulse wave analysis methods. Stiffness index, reflection index (RI), and pulse propagation time were calculated. The mean stiffness index and RI were significantly higher in the diabetic branch retinal vein occlusion group compared with the non-diabetic branch retinal vein occlusion and the healthy controls (for stiffness index: 11.5 ± 2.8 vs. 10.1 ± 2.5 and 8.3 ± 2.0, P < 0.001; and for RI: 75.1 ± 11.7 vs. 65.4 ± 8.4 and 60.2 ± 18.8, P < 0.001, respectively), whereas the pulse propagation time was significantly lower in the diabetic group (156.4 ± 32.3 vs. 174.4 ± 46.5 and 205.0 ± 58.5, P < 0.001, respectively). There was a significant negative correlation between visual acuity and stiffness index (r = -0.512, P < 0.001). Besides, there was also a significant positive correlation between visual acuity and pulse propagation time (r = 0.398, P < 0.001). This study demonstrated that the stiffness index and RI values were higher in patients with branch retinal vein occlusion compared to the healthy subjects.

Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in Branch Retinal Vein Occlusion

Purpose. To evaluate the neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio(PLR) value in the development of branch retinal vein occlusion (BRVO)patients. Methods. 81 patients with BRVO and 81 age and sex-matched subjects were recruited as the control group. The BRVO diagnosis was confirmed under comprehensive ophthalmologic examinations. NLR and PLR parameters obtained from peripheral blood were recorded. Results. Both the mean NLR and PLR was significantly higher in the BRVO group compared with the control group (p < 0.001). In ROC analysis, the AUC for NLR was 0.82, and NLR of >2.48 predicted BRVO with a sensitivity of 58% and specificity of 98%. The AUC for PLR was 0.78, and PLR of >110.2 predicted BRVO with a sensitivity of 72% and specificity of 72%. Conclusion. The current study demonstrated that BRVO patients had increased NLR and PLR levels compared with control subjects. The NLR and PLR may be used as independent predictors for identifying risk for the development of BRVO.

The short-term effects of intravitreal aflibercept injections and dexamethasone implant on ocular hemodynamics in retinal vein occlusions.

PurposeTo determine the early effects of intravitreal anti-VEGF and dexamethasone application on blood flow velocities in patients with retinal vein occlusions.MethodsThe ophthalmic (OA) and the central retinal arteries (CRAs) of the affected and unaffected eyes of 21 patients with central retinal vein occlusion (CRVO), and 26 patients with branch retinal vein occlusion (BRVO) were investigated by Color Doppler imaging (CDI). Peak systolic volume (PSV), end diastolic volume (EDV), and average blood velocity (Vmean) of the CRA and OA were measured and resistive indexes (RI) were calculated at pre-injection and the 1st week and 1st month post-injection.ResultsThere was no statistically significant difference between the OA values for affected and unaffected eyes in the CRVO group before treatment. The CRA, EDV, and Vmean values were significantly lower in affected eyes. Blood flow velocities of both CRA and OA were not significantly different than in the fellow unaffected eyes in the BRVO group. The differences between PSV, EDV, and Vmean measurements of OA and CRA at different times pre- and post-injection in response to anti-VEGF and dexamethasone treatment in the CRVO group were significant; but there was no difference in RI value. OA blood flow velocity measurements were not statistically different post-injection in the BRVO group; however, the values of PSV and EDV of CRA decreased post-injection.ConclusionIntravitreal anti-VEGF and dexamethasone implant may induce retinal arteriolar vasoconstriction in patients with retinal vein occlusion.