Diagnosis Of Retinal Vein Occlusion Research Articles

Vision-related quality of life in patients with retinal vein occlusion.

This study aims to assess the vision-related quality of life in patients with retinal vein occlusion (RVO) among those referred to Labbafinejad Medical Center and Imam Hossein Hospital between 2019 and 2021. This comparative study included 37 eligible patients diagnosed with various types of RVO, with an average age of 61 ± 9. To ensure data validity, we included 74 age- and sex-matched healthy individuals. Only cases with a definitive diagnosis of RVO, confirmed by two retina specialists (ND and RN), were included. We assessed the vision-related quality of life of our participants using the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25). All participants underwent interviews. In our study, we examined the vision-related quality of life in different subgroups of RVO patients. Overall, RVO patients had a significantly lower total VRQoL score compared to healthy individuals (P < 0.001), except in the subscale analysis of specific factors such as ocular pain, color vision, and driving, where no statistically significant difference was observed. A statistically significant difference was found in the comparison of subgroups, indicating lower VRQoL in central retinal vein occlusion (CRVO) patients (P = 0.010). Furthermore, a significant correlation was observed between lower VRQoL and decreased vision (P = 0.009) as well as longer disease duration (P = 0.011). Retinal vein occlusion can significantly reduce vision-related quality of life, particularly in more severe cases.

Intelligent diagnosis of retinal vein occlusion based on color fundus photographs.

To develop an artificial intelligence (AI) diagnosis model based on deep learning (DL) algorithm to diagnose different types of retinal vein occlusion (RVO) by recognizing color fundus photographs (CFPs). Totally 914 CFPs of healthy people and patients with RVO were collected as experimental data sets, and used to train, verify and test the diagnostic model of RVO. All the images were divided into four categories [normal, central retinal vein occlusion (CRVO), branch retinal vein occlusion (BRVO), and macular retinal vein occlusion (MRVO)] by three fundus disease experts. Swin Transformer was used to build the RVO diagnosis model, and different types of RVO diagnosis experiments were conducted. The model's performance was compared to that of the experts. The accuracy of the model in the diagnosis of normal, CRVO, BRVO, and MRVO reached 1.000, 0.978, 0.957, and 0.978; the specificity reached 1.000, 0.986, 0.982, and 0.976; the sensitivity reached 1.000, 0.955, 0.917, and 1.000; the F1-Sore reached 1.000, 0.955 0.943, and 0.887 respectively. In addition, the area under curve of normal, CRVO, BRVO, and MRVO diagnosed by the diagnostic model were 1.000, 0.900, 0.959 and 0.970, respectively. The diagnostic results were highly consistent with those of fundus disease experts, and the diagnostic performance was superior. The diagnostic model developed in this study can well diagnose different types of RVO, effectively relieve the work pressure of clinicians, and provide help for the follow-up clinical diagnosis and treatment of RVO patients.

Risk of Stroke, Myocardial Infarction, Deep Vein Thrombosis, Pulmonary Embolism, and Death After Retinal Vein Occlusion

To examine rates of stroke, myocardial infarction (MI), deep vein thrombosis (DVT), pulmonary embolism (PE), and death in patients after retinal vein occlusion (RVO) compared to controls. Retrospective cohort study. An aggregated electronic health records research network, TriNetX (Cambridge, MA, USA), was used to identify patients with diagnosis of RVO and a control group of patients with cataract. Patients were excluded if they had history of stroke, MI, DVT, or PE within 2 years of diagnosis of RVO or cataract. Propensity score matching was performed to control for baseline demographics and medical comorbidities. Main outcomes included relative risk (RR) of death, stroke, MI, DVT, and PE after RVO compared to matched controls. 45304 patients were included in each cohort. There was elevated risk of death in the RVO cohort compared to the control cohort at 1 (RR: 1.30, p<0.01), 5 (RR: 1.22, p<0.01), and 10 years (RR:1.08, p<0.01). There was elevated risk of stroke at 1 (RR:1.61, p<0.01), 5 (RR:1.31, p<0.01), and 10 years (RR: 1.18, p<0.01). There was elevated risk of MI at 1 (RR:1.26, p<0.01) and 5 years (RR:1.13, p<0.01), but not at 10 years (RR:1.06, p=0.12). There was mildly elevated risk of DVT at 1 year (RR: 1.65, p<0.01), but not at 5 (RR: 0.94, p=0.94) or at 10 years (RR: 1.05, p=0.37), There was no elevated risk of PE at 1 (RR: 0.98, p=0.80), 5 (RR: 0.95, p=0.42), or 10 years (RR: 0.85, p=0.40). There is an increased rate of death, stroke, and MI after RVO compared to matched controls. We emphasize the need for long term systemic evaluation after RVO.

Predictors of response to a lapse in anti-VEGF treatment in patients with macular edema secondary to retinal vein occlusion

BackgroundMacular edema (ME) in the setting of retinal vein occlusions (RVO) is a common cause of vision loss worldwide. Anti-vascular endothelial growth factor (anti-VEGF) injections are the gold standard for ME secondary to RVO. Despite their efficacy, anti-VEGF injections carry significant burdens for patients, resulting in high rates of loss to follow-up and treatment lapses. MethodsA sub-analysis examining the effects of a treatment lapse in RVO patients was conducted. Sixty patients were included and separated into vision-loss and stable-vision groups based on change in vision after a lapse. A logistic regression with age, body mass index (BMI), history of dyslipidemia, and time since diagnosis of RVO as predictors was used to predict whether patients would experience vision loss after a lapse. ResultsThe average lapse was 5.6 months and similar in the vision-loss and stable-vision groups. At baseline, the vision-loss group was older and had a lower BMI (p < 0.05). Age and history of dyslipidemia increased the odds of vision loss by factors of 1.23 (range, 1.10–1.45) and 8.40 (range, 1.62–66.2), respectively. BMI and time since RVO diagnosis decreased the odds of vision loss by factors of 0.83 (range, 0.69–0.95) and 0.95 (range, 0.90–0.99), respectively. The final model had a specificity of 87.5% and a sensitivity of 70.0%. ConclusionsPatients’ responses to treatment lapses for ME secondary to RVO can be predicted with reasonable accuracy using readily available clinical data, particularly age, BMI, time since diagnosis, and history of dyslipidemia. Providers should consider these factors when counselling patients and determining follow-up schedules.

Estimating the rate of severe visual loss (wipe-out) following cataract surgery, a British Ophthalmological Surveillance Unit (BOSU) study.

A sudden, irreversible reduction in visual acuity ('wipe-out') is a feared complication of cataract surgery. Current literature on wipe-out is limited in quantity and quality, and largely predates modern cataract surgery and imaging techniques. The objectives of our study were to estimate the incidence of wipe-out and to identify potential risk factors. We prospectively collated cases of wipe-out occurring in the UK during a 25-month study period using the British Ophthalmic Surveillance Unit reporting system. A total of 21 potential cases of wipe-out were reported, 5 of which met all inclusion and exclusion criteria. The estimated incidence of wipe-out during the study period was 0.00000298, or approximately 3 cases per million cataract operations. All cases of wipe-out occurred exclusively in patients with advanced glaucoma (mean deviation -21.0 decibels or worse in the operated eye), with an over-representation of black people (40%) in our case series. A prior diagnosis of retinal vein occlusion (60%) and elevated post-operative IOP (40%) were more common among individuals suffering from wipe-out compared to the general population, suggesting these factors may contribute to the pathogenesis of wipe-out. Our study shows that wipe-out is a rare complication, affecting approximately 3 per million undergoing cataract surgery. Patients with advanced glaucoma, black patients, and those with previous retinal vein occlusions may be at greater risk of wipe-out. We hope that the findings of our study will be used to help inform treatment decision-making and the cataract surgery consent process.

Clinical Features and Visual Prognosis of Retinal Vein Occlusion in Those under 50 Years Old

Purpose: To analyze the clinical features and visual prognosis of retinal vein occlusion (RVO) in patients under 50 years of age.Methods: A retrospective analysis of medical records of 36 patients under 50 years of age diagnosed with RVO from January 2016 to October 2021.Results: The mean age was 39.53 ± 9.98 years and 50%, 44.4%, and 5.6% had branch, central, and hemi-central RVO, respectively. Before the RVO diagnosis, systemic disease had been diagnosed in 38.9%. Further, 13.89% of the cases had a new systemic disease diagnosed after the diagnosis of RVO. Hypercholesterolemia was observed in 47.6%. The initial visual acuity (VA), best corrected visual acuity (BCVA), and central subfield thickness (CST) showed significant correlations with the final VA, BCVA, and CST.Conclusions: In patients with RVO under the age of 50 years, the initial VA and CST can be used as indicators to determine whether treatment is necessary by reflecting the final VA and CST. The initial VA and CST can also be used to predict the visual prognosis. Even at a young age, if complications occur, the visual prognosis of RVO may be poor, so an evaluation of the patient’s general condition is essential, especially the blood cholesterol level.

Optical coherence tomography angiography evaluation of retinal and optic disc microvascular morphological characteristics in retinal vein occlusion.

To evaluate microvascular morphological characteristics of the retina and optic disc (OD) in retinal vein occlusion (RVO) patients using optical coherence tomography angiography (OCTA), compare the results to age- and gender-matched healthy subjects, and determine correlations between OCTA parameters and best-corrected visual acuity (BCVA) and age. In this retrospective study, right eyes of 53 RVO patients and 51 healthy subjects were compared regarding BCVA, as well as superficial and deep capillary plexus (SCP and DCP) vessel densities (VDs), foveal avascular zone (FAZ) parameters, outer retinal and choriocapillaris flow areas, OD whole and peripapillary VDs, and retinal nerve fiber layer thickness (RNFLT). Retinal vein occlusion patients were further divided into subgroups based on therapy and risk factors, and OCTA parameters were compared. Retinal vein occlusion rate or OCTA parameters did not differ significantly by gender (p>0.05). Retinal vein occlusion patients had significantly decreased BCVA, whole, parafoveal and perifoveal SCP and DCP VDs, as well as VDs 300µm area around FAZ (FD-300) than healthy subjects (p<0.001). Their choriocapillaris flow area, RNFLT, whole and peripapillary VDs were also affected. However, FAZ area did not differ significantly between groups. Superior RNFLT (p=0.016) and whole peripapillary VD (p<0.001) differed significantly between laser photocoagulation-treated and non-treated patients. The remaining OCTA parameters revealed no significant differences CONCLUSIONS: The RVO and its therapeutic alternatives may affect both OD and retinal VDs. Given its numerous benefits, it seems that OCTA will be used more frequently in clinics for RVO diagnosis, monitoring, and therapeutic response evaluation.

Risk of retinal vein occlusion following COVID-19 vaccination: a self-controlled case series.

To evaluate the association between COVID-19 vaccination and retinal vein occlusion (RVO). This multicentre self-controlled case series included patients with RVO seen in five tertiary referral centres in Italy. All adults who received at least one dose of the BNT162b2, ChAdOx1 nCoV-19, mRNA-1273 or Ad26.COV2.S vaccine and had a first diagnosis of RVO between January 01, 2021, and December 31, 2021 were included. Incidence rate ratios (IRRs) of RVO were estimated using Poisson regression, comparing rates of events in a 28-day period following each dose of vaccination and in the unexposed control periods. 210 patients were included in the study. No increased risk of RVO was observed after the first dose (1-14 days IRR: 0.87, 95% CI: 0.41-1.85; 15-28 days IRR: 1.01, 95% CI: 0.50-2.04; 1-28 days IRR: 0.94, 95% CI: 0.55-1.58) and second dose of vaccination (1-14 days IRR: 1.21, 95% CI: 0.62-2.37; 15-28 days IRR: 1.08, 95% CI: 0.53-2.20; 1-28 days IRR: 1.16, 95% CI: 0.70-1.90). No association between RVO and vaccination was found in subgroup analyses by type of vaccine, gender and age. This self-controlled case series found no evidence of an association between RVO and COVID-19 vaccination.

Socio-demographic factors and selected clinical characteristics of patients with retinal vein occlusions in transitional Albania

Aim: The aim of our study was to assess the distribution of socio-demographic factors and the clinical profile of individuals diagnosed with retinal vein occlusion (RVO) in Albania, a former communist country in South-eastern Europe which has been undergoing a rapid transition in the past decades.&#x0D; Methods: This study was carried out in 2013-2016 at the Primary Health Care Centre No. 2 in Tirana municipality, which is the capital of Albania. During this timeframe, on the whole, 44 patients were diagnosed with RVO at this primary health care centre (17 women and 27 men; overall mean age: 69.5±11.5 years). The diagnosis of RVO was based on signs and symptoms indicating a quick reduction of the sight (vision), fundoscopy, fluorescein angiography and the optical coherence tomography. Data on socio-demographic factors and clinical characteristics were also gathered for each study participant.&#x0D; Results: The prevalence of glaucoma was considerably higher in men than in women (67% vs. 24%, respectively, P=0.01). Diabetic retinopathy was somehow more prevalent in women than in men (18% vs. 11%, respectively), whereas an opposite finding was noted for the presence of hypertensive retinopathy (6% vs. 11%, respectively). The prevalence of cataract was higher in female patients compared with their male counterparts (18% vs. 7%, respectively, P=0.36). Both macular oedema and papillary oedema were almost equally distributed in men and in women (22% vs. 18% and 4% vs. 6%, respectively). All female patients had comorbid conditions compared to 85% of their male counterparts (P=0.15). The prevalence of hypertension was almost identical in both sexes (52% in men vs. 53% in women), whereas the prevalence of diabetes was somehow higher in men than in women (26% vs. 18%, respectively). &#x0D; Conclusion: This is one of the very few studies informing about the distribution of socio-demographic factors and selected clinical characteristics of individuals diagnosed with RVO in transitional Albania.&#x0D;

Hypermixed Convolutional Neural Network for Retinal Vein Occlusion Classification.

Retinal vein occlusion (RVO) is one of the most common retinal vascular diseases leading to vision loss if not diagnosed and treated in time. RVO can be classified into two types: CRVO (blockage of the main retinal veins) and BRVO (blockage of one of the smaller branch veins). Automated diagnosis of RVO can improve clinical workflow and optimize treatment strategies. However, to the best of our knowledge, there are few reported methods for automated identification of different RVO types. In this study, we propose a new hypermixed convolutional neural network (CNN) model, namely, the VGG-CAM network, that can classify the two types of RVOs based on retinal fundus images and detect lesion areas using an unsupervised learning method. The image data used in this study is collected and labeled by three senior ophthalmologists in Shanxi Eye Hospital, China. The proposed network is validated to accurately classify RVO diseases and detect lesions. It can potentially assist in further investigating the association between RVO and brain vascular diseases and evaluating the optimal treatments for RVO.

Prevalence of homocysteinemia and effect of vitamin supplementation in retinal vein occlusion

ObjectiveThe objective of this study was to determine the prevalence of homocysteinemia in patients with retinal vein occlusion (RVO). We investigated the association of B complex vitamin (BCV) and multivitamin...

Development and Application of an Intelligent Diagnosis System for Retinal Vein Occlusion Based on Deep Learning.

This study is aimed at developing an intelligent algorithm based on deep learning and discussing its application for the classification and diagnosis of retinal vein occlusions (RVO) using fundus images. A total of 501 fundus images of healthy eyes and patients with RVO were used for model training and testing to investigate an intelligent diagnosis system. The images were first classified into four categories by fundus disease specialists: (i) healthy fundus (group 0), (ii) branch RVO (BRVO) (group 1), (iii) central RVO (CRVO) (group 2), and (iv) macular branch RVO (MBRVO) (group 3), before being diagnosed using the ResNet18 network model. Intelligent diagnoses were compared with clinical diagnoses. The specificity of the intelligent diagnosis system under each attention mechanism was 100% in group 0 and also revealed a high sensitivity of over 95%, F1 score of over 97%, and an accuracy of over 97% in this group. For the other three groups, the specificities of diagnosis ranged from 0.45 to 0.91 with different attention mechanisms, in which the ResNet18+coordinate attention (CA) model had the highest specificities of 0.91, 0.88, and 0.83 for groups 1, 2, and 3, respectively. It also provided a high accuracy of over 94% with a coordinate attention mechanism in all four groups. The intelligent diagnosis and classifier system developed herein based on deep learning can determine the presence of RVO and classify disease according to the site of occlusion. This proposed system is expected to provide a new tool for RVO diagnosis and screening and will help solve the current challenges due to the shortage of medical resources.

Evaluation of off-label anti-vascular endothelial growth factor and steroid implant medication uses in macular edema due to retinal vein occlusion in Turkey.

Retinal vein occlusion (RVO) is one of the most common causes of vision loss. Anti-vascular endothelial growth factor (anti-VEGF) drugs, ranibizumab and aflibercept, and corticosteroid implants are approved treatment options for RVO-related macular edema (ME) in Turkey. To the best of our knowledge, there is no data regarding the off-label use of these drugs for RVO in English literature. We aimed to evaluate the clinical and demographic characteristics of off-label drug use applications in Turkey for RVO. Applications made to the Turkish Medicines and Medical Devices Agency between January 1 and December 31, 2018, for the use of off-label drugs (ranibizumab, aflibercept, dexamethasone implant) for the diagnosis of RVO from hospitals across Turkey were retrospectively analysed. Data of the applications, such as demographic characteristics, previous treatment regimens, reasons for applications, applicant hospitals and their regions, were recorded. There were 291 approved applications for RVO. The mean age of the patients was 64.88 ± 10.78 years, 48.8% were male, and 51.2% were female. Of these applications, 44.7% were for aflibercept, 35.7% for ranibizumab and 19.6% for dexamethasone implant. No application was made for bevacizumab since it could be used without needing for an application. The most common reasons for applications were due to dose limitations, failure to complete loading doses, and glaucoma, respectively. In terms of the distribution of the applicant hospitals, public university hospitals ranked first with 72.5%, training and research hospitals ranked second with 14.7% and foundation university hospitals ranked third with 13.1% rates. The practice of drug use in RVO in Turkey has changed as of the beginning of 2019. Stepwise therapy has been accepted by the drug regulatory agency Turkish Medicines and Medical Devices Agency. Utilization of licensed drugs, aflibercept, ranibizumab and dexamethasone has been allowed only after administration of 3 doses of intravitreal bevacizumab. After 3 doses of bevacizumab, the physician may continue either with bevacizumab again or a dexamethasone implant. If there is a reason such as the presence of glaucoma, the physician may skip dexamethasone and switch to aflibercept and ranibizumab, but in this case, dexamethasone cannot be administered to the patient for life. The evaluation of the off-label treatments of RVO, which is one of the most frequently followed diseases in retina clinics, not only contributes to the literature but also provides information regarding the most frequently applied treatments and the physicians' off-label drug preferences for RVO.

Evaluation of Systemic Endothelial Dysfunction in Retinal Vein Occlusions.

Objectives:Our aim in this study was to evaluate the systemic endothelial dysfunction status and carotid intima-media thickness (CIMT) in patients with retinal vein occlusion (RVO).Methods:Seventy-six patients who presented to the clinic with the diagnosis of RVO and 76 age- and gender-matched healthy individuals without a RVO history were included in the study. The patients’ best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measures, and diabetes, hypertension, hyperlipidemia, carotid artery disease, body mass index, and smoking histories were recorded. The endothelial function levels of the patients, pulse wave velocity (PWV), flow-mediated dilation (FMD), and CIMT were measured. Endothelial dysfunction was detected by applying the FMD technique to the brachial artery. CIMT was evaluated by B-mode ultrasonography. Serum hematological parameters were evaluated.Results:BCVA (logMAR) was 1.39±1.30 in patients with RVO and 0.028±1.22 in the control group (p<0.001). CMT was 588.76±104.02 µm in patients with RVO and 265.20±45.11 µm in the control group (p=0.001). Hypertension, diabetes, and hyperlipidemia were found to be significantly higher in patients with RVO (p-value 0.001, 0.002, and 0.001, respectively). There was a significant difference between the groups in terms of FMD, PWV, and CIMT (all of them, p<0.001).Conclusion:The deterioration of FMD and PWV, which are indicators of endothelial dysfunction in patients with RVO, suggests that systemic endothelial dysfunction may play a role in the pathogenesis of RVO. Comprehensive studies with more patient participation are needed.

Novel Association between Opioid Use and Increased Risk of Retinal Vein Occlusion Using the National Institutes of Health All of Us Research Program.

Purpose:To assess for risk factors for retinal vein occlusion (RVO) among participants in the National Institutes of Health All of Us database, particularly social risk factors that have not been well studied, including substance use.Design:Retrospective, case-control study.Participants:Data were extracted for 380 adult participants with branch retinal vein occlusion (BRVO), 311 adult participants with central retinal vein occlusion (CRVO), and 1520 controls sampled among 311 640 adult participants in the All of Us database.Methods:Data were extracted regarding demographics, comorbidities, income, housing, insurance, and substance use. Opioid use was defined by relevant diagnosis and prescription codes, with prescription use > 30 days. Controls were sampled at a 4:1 control to case ratio from a pool of individuals aged > 18 years without a diagnosis of RVO and proportionally matched to the demographic distribution of the 2019 U.S. census. Multivariable logistic regression identified medical and social determinants significantly associated with BRVO or CRVO. Statistical significance was defined as P < 0.05.Main Outcome Measure:Development of BRVO or CRVO based on diagnosis codes.Results:Among patients with BRVO, the mean (standard deviation) age was 70.1 (10.5) years. The majority (53.7%) were female. Cases were diverse; 23.7% identified as Black, and 18.4% identified as Hispanic or Latino. Medical risk factors including glaucoma (odds ratio [OR], 3.29; 95% confidence interval [CI], 2.22–4.90; P < 0.001), hypertension (OR, 2.15; 95% CI, 1.49–3.11; P < 0.001), and diabetes mellitus (OR, 1.68; 95% CI, 1.18–2.38; P = 0.004) were re-demonstrated to be associated with BRVO. Black race (OR, 2.64; 95% CI, 1.22–6.05; P = 0.017) was found to be associated with increased risk of BRVO. Past marijuana use (OR, 0.68; 95% CI, 0.50–0.92; P = 0.013) was associated with decreased risk of BRVO; however, opioid use (OR, 1.98; 95% CI, 1.41–2.78; P < 0.001) was associated with a significantly increased risk of BRVO. Similar associations were found for CRVO.Conclusions:Understanding RVO risk factors is important for primary prevention and improvement in visual outcomes. This study capitalizes on the diversity and scale of a novel nationwide database to elucidate a previously uncharacterized association between RVO and opioid use.

Retinal vein occlusion: drug targets and therapeutic implications

Introduction The pathogenesis of retinal vein occlusion (RVO) is extremely complex and includes several mediators. These mediators represent potential drug targets that can be used in the development of intravitreal drugs. Areas covered PubMed/MEDLINE databases were accessed between April-May 2021 to find the most relevant scientific papers regarding drug targets and therapeutic implications in RVO, focusing on current therapeutic options and potential cornerstones of future advances in treatment. Expert opinion Before the introduction of intravitreal therapies, the visual outcome following a diagnosis of RVO was extremely poor. Anti-VEGF and corticosteroid treatments have radically changed RVO prognosis, helping to preserve patients’ visual function and their quality of life. According to current clinical data, anti-VEGF and corticosteroid drugs are associated with both pros and cons; the present recommendation is to employ anti-VEGF molecules as a first-line treatment. Advances in our understanding of the biomolecular characteristics of RVO offer a solid basis for the development of new therapeutic targets and treatments.

Platelet and Thrombophilia-Related Risk Factors of Retinal Vein Occlusion.

Retinal vein occlusion (RVO) is a heterogenous disorder in which the formation of a thrombus results in the retinal venous system narrowing and obstructing venous return from the retinal circulation. The pathogenesis of RVO remains uncertain, but it is believed to be multifactorial and to depend on both local and systemic factors, which can be divided into vascular, platelet, and hypercoagulable factors. The vascular factors include dyslipidaemia, high blood pressure, and diabetes mellitus. Regarding the platelet factors, platelet function, mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (PLCR) play key roles in the diagnosis of retinal vein occlusion and should be monitored. Nevertheless, the role of a hypercoagulable state in retinal vein occlusion remains unclear and requires further studies. Therefore, the following article will present the risk factors of RVO associated with coagulation disorders, as well as the acquired and genetic risk factors of thrombophilia. According to Virchow’s triad, all factors mentioned above lead to thrombus formation, which causes pathophysiological changes inside venous vessels in the fundus of the eye, which in turn results in the vessel occlusion. Therefore, a diagnosis of retinal vein occlusion should be based on both eye examination and general examination, including laboratory tests.

3-3ELEVATED MEAN PLATELET VOLUME AND RETINAL VEIN OCCLUSION IN HYPERTENSIVE PATIENTS: A META-ANALYSIS

Background: In comparison to smaller ones, larger platelets indicate altered reactivity and aggregation. Mean platelet volume (MPV), knowingly used to assess the size, is significantly elevated in hypertension. High MPV is equivalent to a high risk of thrombotic events. Retinal vein occlusion (RVO) is one of the most common extracardiac complications of hypertension, which may lead to vision loss. Assessment of MPV may help to determine the development of the disease. Objective: We aimed to analyze if elevated MPV was associated with the incident of RVO, particularly in hypertensive patients. Method: A literature search was conducted through PubMed, Cochrane, and Science Direct for primary studies. The abstracts and full text were scanned for potentially relevant articles that fulfilled the inclusion criteria. The quality assessment was done using the Newcastle-Ottawa Quality Assessment Scale (NOS) for case-control studies. We analyzed the data using STATA 14.1. Result: Four studies (363 RVO patients and 256 controls) were incorporated into this meta-analysis. Due to the high heterogeneity, a random-effects model was used to calculate the pooled SMD and corresponding 95% confidence intervals. Results have indicated significant increase of MPV levels (SMD = 1.008, 95% CI 0.819–1.197, P &lt; 0.001) and insignificant increase of platelet count levels (SMD = 0.149, 95% CI 0.016–0.313, P = 0.076) in hypertensive patients with RVO compared to controls. Conclusion: We found that MPV is strongly associated with the presence of RVO in hypertensive patients. Further studies are required to ascertain the potential clinical use of this simple and relatively inexpensive marker in RVO diagnosis.

Neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio in retinal vein occlusion

BackgroundTo evaluate the association between neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR) and the development of retinal vein occlusion.MethodsOne hundred and eleven patients and 88 control subjects were enrolled. Retinal vein occlusion diagnosis was clinically made with fundus examination. NLR and PLR values were compared between groups.ResultsNeutrophil levels were found to be comparable between the two groups (p = 0.47). Lymphocyte levels were lower in retinal vein occlusion patients (p = 0.001). NLR was significantly higher in retinal vein occlusion patients (p = 0.001). Platelet counts were found to be comparable in the two groups (p = 0.75). PLR was significantly higher in retinal vein occlusion patients (p = 0.001). According to the receiver operating characteristic curve analysis, the optimal cut‐off values of NLR and PLR to predict retinal vein occlusion were > 1.63 and > 98.50, respectively.ConclusionsThe present study showed that higher NLR and PLR were associated with the development of retinal vein occlusion. Also, NLR and PLR may be used as predictive tools for identifying risk for retinal vein occlusion.

Visual and Anatomic Outcomes following Cataract Surgery in Patients with Pre-operative Macular Edema Due to Retinal Vein Occlusions Managed with Intravitreal anti-VEGF

ABSTRACT Purpose The purpose of this study was to investigate the visual and anatomic outcomes in patients with macular edema due to retinal vein occlusions (RVO) who were actively managed with intravitreal anti-vascular endothelial growth factor (VEGF) before and after cataract surgery. Methods Retrospective, cohort study of all patients with RVO who underwent cataract surgery and were receiving intravitreal anti-VEGF injections from January 1st, 2012 through October 31st, 2018. There were 31 eyes that underwent cataract surgery and received at least one intravitreal anti-VEGF injection for a diagnosis of RVO within 6 months prior to surgery. Data collected included the development of subretinal or intraretinal macular fluid in the 6 months following surgery, timing of injections, number of injections, best corrected visual acuity (BCVA), and central subfield thickness (CST). Results There was a significant improvement between pre- and post-operative BCVA when comparing all eyes (p values < .0001) and no significant difference in CST before and after surgery (p > .05). Eyes without fluid pre-operatively saw an improvement in visual acuity, but with an initial significant increase in CST (p = .03) that normalized over time (p = .33) without an increase in frequency of anti-VEGF injections. Conclusion Patients with cataracts who are actively managed for macular edema due to RVO with anti-VEGF agents may undergo cataract surgery, knowing they will have a transient increase in macular thickness that resolves without adjusting the frequency of intravitreal injections and is not visually significant.