Impending Central Retinal Vein Occlusion Research Articles

A case of covid-19 who developed cilioretinal artery obstruction associated with impending central retinal vein occlusion after covid-19 infection

A case of covid-19 who developed cilioretinal artery obstruction associated with impending central retinal vein occlusion after covid-19 infection

Hypertension, hyperlipidaemia and thrombophilia as the most common risk factors for retinal vein occlusion in patients under 50 years.

Cardiovascular (CV) diseases are the most common risk factors (RFs) for retinal vein occlusion (RVO) development in general. The aim of this study was to identify the most frequent causes of RVO in patients under 50. We retrospectively evaluated a group of patients with RVO under 50 years. The parameters of interest included age and sex, RVO type, presence of arterial hypertension (HT), hyperlipidaemia (HLD), diabetes mellitus (DM), congenital thrombophilic disorder (TD), obstructive sleep apnoea syndrome (OSAS), thyroid eye disease (TED), use of hormone contraception (HC) or hormone replacement therapy (HRT), glaucoma and other potential RFs. Patients with central RVO (CRVO), hemi-central RVO (HRVO), branch RVO (BRVO), impending CRVO and combined arterial-venous (AV) occlusion were included. The group consisted of 110 eyes of 103 patients. CV disease was the most common systemic abnormality. 55.3% patients had HT, 17.5% had HLD. TD was the third most frequent RF (12.6%). The cohort also included patients with DM (6.8%), glaucoma (6.8%) and women using HC/HRT (26.2% of female patients). There were isolated cases of RVO due to retinal vasculitis, intense exercise, antiphospholipid syndrome and COVID-19 pneumonia. None of the patients had OSAS, TED or a haemato-oncological disease. The etiology remained unexplained in 20.4% patients. No difference was observed in RF occurrence between patients with CRVO and HRVO and those with BRVO. The most common systemic abnormality in our cohort was CV disease, especially HT and HLD. The risk factors for central, hemi-central and branch RVOs were similar.

Paracentral acute middle maculopathy associated with hypoperfusion of the cilioretinal artery and impending central retinal vein occlusion.

Paracentral acute middle maculopathy is defined as ischemia of the deep retinal layers. We report an unusual case of paracentral acute middle maculopathy associated with hypoperfusion of the cilioretinal artery and impending central retinal vein occlusion in a young male with no previous comorbidities. The patient was a 22-year-old male complaining about a sudden loss of vision in his right eye upon awakening. Fundus examination showed optic disk edema, and increased tortuosity of the retinal veins and a few retinal hemorrhages. Swept-source optical coherence tomography found a hyperreflective band that was more pronounced at the level of the inner nuclear layer of the retina. These findings led us to a diagnosis of paracentral acute middle maculopathy associated with hypoperfusion of the cilioretinal artery. The finding of paracentral acute middle maculopathy on optical coherence tomography demands a proper investigation of its cause, because it has an intimate association with vascular diseases and is not an isolated entity. In our case, we could not identify the etiology of the unilateral event in this young male, although dehydration due to alcohol consumption and subsequent hypotension might have played a role in this ischemic event.

Reversal of impending central retinal vein occlusion secondary to hyperleukocytosis in chronic myeloid leukemia by leukapheresis: a case report

We report an uncommon case of bilateral impending central retinal vein occlusion (CRVO) in a young girl with newly diagnosed chronic myeloid leukaemia (CML) and its successful reversal with leukapheresis. A young girl presented with vomiting and fever. Examination revealed hepatosplenomegaly and multiple enlarged lymph nodes. Investigations show severe hyperleukocytosis and anaemia. Bone marrow aspirate and trephine biopsy confirmed CML in the chronic phase. She was promptly referred to the ophthalmology team for assessment of vasculopathy. Bilateral fundus showed swollen and hyperaemic optic discs. There were dilated and tortuous retinal venules with perivascular white cell extravasation, scattered intraretinal haemorrhages, and Roth spots at mid-periphery. She received four cycles of leukapheresis and, consequently, her leukocytes reduced dramatically with associated significant improvement in fundus findings.
 This case highlights uncommon impending CRVO in a young girl and the dramatic improvement in fundus signs following leukapheresis that halted and reversed the progression of impending CRVO.

Impending Central Retinal Vein Occlusion

Central retinal vein occlusion (CRVO) may present with varied clinical manifestations, ranging from mild blurred vision and scattered retinal hemorrhages to severe vision loss, optic nerve swelling, pronounced retinal hemorrhages, collateral retinal vessel formation and neovascularization. Impending CRVO, also known as partial CRVO, is a relatively poorly-defined sub-classification of the CRVO condition. Those affected are either asymptomatic or may complain of mild, often transient episodes of blurring of vision and present with venous dilation and tortuosity but only a few widely scattered flame-shaped retinal hemorrhages. As an impending CRVO may be the prodromal phase of an acute CRVO, this diagnosis requires careful monitoring of the patient for progression. The following case outlines the differential diagnosis, sequelae and inter-professional management of an impending central retinal venous occlusion.

Central Retinal Artery Occlusion Following Central Retinal Vein Occlusion- A Case Report

A 73-year-old gentleman with diabetes mellitus was found to have impending central retinal vein occlusion (CRVO), on routine eye check-up. Despite initiation of anti-platelet agent, he developed ischaemic CRVO two months later, with severe macula oedema. His systemic investigations showed good diabetic control, no blood dyscrasia/hypercoagulable state, normal lipid profile and inflammatory markers. Echocardiogram was normal. A month later, arteriolar attenuation was noted with rubeosis irides, and fluorescein angiogram study confirmed central retinal artery occlusion (CRAO). After ruling out the systemic risk factors, we postulate two possible anatomical related patho-mechanism of CRAO following CRVO: 1, CRVO converts the retinal circulation into a closed loop, results in complete hemodynamic block of the retinal circulation, and hence secondary CRAO; 2, swollen retinal nerve fibres at the optic nerve head secondary to CRVO cause compression to the retinal artery at the level of the lamina cribrosa, this compression is further aggravated by the increased in intraocular pressure (IOP), and hence secondary CRAO.

Clinical Progress in Impending Central Retinal Vein Occlusion

PurposeImpending central retinal vein occlusion is associated with mild or no loss of vision; however, its progress and vision prognosis have not been clearly defined until now. Therefore, we studied the progress and prognoses in patients with impending central retinal vein occlusion.MethodsFor this study, we selected ten subjects who had been diagnosed with impending central retinal vein occlusion, and we retrospectively reviewed their progress and prognoses.ResultsThe average age of the subjects was 31.0 years (18 to 48 years). Eight patients were male and two were female. The average observational period was 5.5 months. Six out of ten subjects were found to have no underlying systemic disease, four subjects had underlying disease. All ten patients were affected unilaterally. When initially tested, the affected eyes showed an average vision of LogMar 0.30. The final vision test revealed an average of LogMar 0.04, which indicates good progress and prognosis. In one patient, retinal hemorrhage and macular edema progressively worsened after the diagnosis, and the patient was treated with radial optic neurotomy.ConclusionsThe cases of impending central retinal vein occlusion that we observed seemed to primarily affect young patients with generally good prognoses. However, in some cases, the degrees of obstruction and hemorrhage increased as time progressed. This suggests that impending central retinal vein occlusion could develop into the prodromal phase of an acute attack.

Progression of Impending Central Retinal Vein Occlusion to the Ischemic Variant Following Intravitreal Bevacizumab

A 60-year-old woman who had experienced two episodes of amaurosis fugax in her right eye presented with vision loss. Two weeks earlier, at a private clinic, she was diagnosed with impending central retinal vein occlusion (CRVO) of the right eye and received an intravitreal injection of bevacizumab. Two weeks after this injection she was diagnosed with ischemic CRVO. At 11-weeks post-presentation, extremely ischemic features were observed with fluorescein angiographic findings of severe vascular attenuation and extensive retinal capillary obliteration. At 22-weeks post-presentation she was diagnosed with neovascular glaucoma; she experienced no visual improvement over the following several months.

Impending central retinal vein occlusion associated with cilioretinal artery obstruction

We report a case of a patient with an impending central retinal vein occlusion (CRVO) with cilioretinal artery obstruction, which may help to understand the nature of the retinal hemodynamic changes associated with CRVO which shows direct evidence of arterial vasospasm, suggesting an increased contractility of retinal arteries. The clinical course, with initial retinal whitening along a cilioretinal artery followed by signs of venous stasis, seems to confirm the pathogenesis hypothesis concerning a primary arterial affection due to arterial vasospasm.

Multiple retinal vein occlusions in essential thrombocythemia

PURPOSE: To report the ophthalmoscopic and angiographic evidence of both temporally and spatially independent multiple occlusions of the retinal veins in a patient with essential thrombocythemia. METHODS: Observational case report. Ophthalmic examinations, including fluorescein fundus angiogram, were performed on a 77-year-old male, who was found to have essential thrombocythemia. RESULTS: An acute impending central retinal vein occlusion in the left eye was diagnosed with coexisting old retinal vein occlusions evidenced by white vessels and capillary nonperfusion in both eyes. Peripheral retinal capillary dropout was also found angiographically in the right eye. CONCLUSION: Bilateral multiple occlusions of retinal veins in the present case suggest a prothrombotic tendency in retinal circulation in essential thrombocythemia.

In Vivo Measurement of Ocular Circulation with the Laser Speckle Method—Development of Apparatus and Application in Ophthalmological Research

central retinal vein was 35.5 +/- 3.2 mm/sec with a correlation coefficient between them of 0.91. In a total of 4 eyes with impending central retinal vein or artery occlusion, measurements by the laser speckle method, and CDI method were carried out. The blood velocities measured by the both methods increased along with the treatment. A good correlation between the CDI results and the laser speckle results indicates validity and clinical potential of the present laser speckle method.

Warfarin ® Potassium for Impending Central Retinal Vein Occlusion

Purpose: We reviewed the records of 10 patients who had impending central retinal vein occlusion in order to judge whether anticoagulant treatment with warfarin potassium Warfarin ® was indicated. Patients: Six men and four women, ranging in age from 25 to 83 (average 55) years were studied. Results: Of 6 eyes, retinal hemorrhage disappeared completely within 6 months. Four patients whose visual acuity was 0.1 or less at one month needed photocoagulation. Four other patients whose late venous circulation time at fluorescein angiography improved within 30 seconds had good visual prognosis. Three eyes of four patients aged 65 or older were not successful in regaining their visual acuity. Conclusion: Warfarin ® was not effective for patients who had clearly lost their visual acuity and the elderly in this series. Late venous circulation time at fluorescein angiography was a useful index for this treatment.