Retinal Vein Occlusion Research Articles

Short-term fluctuation of intraocular pressure and influencing factors following intravitreal injection in patients with retinal vascular diseases

AIM: To investigate the patterns of short-term intraocular pressure (IOP) fluctuations and identify the contributing factors following intravitreal injection in patients with retinal vascular diseases. METHODS: Totally 81 patients were enrolled in this case control study. Eyes were categorized into 7 groups, including age-related macular degeneration (AMD), polypoidal choroidal vasculopathy (PCV), idiopathic choroidal neovascularization (CNV), proliferative diabetic retinopathy (PDR), diabetic macular edema (DME), macular edema secondary to branch (BVOME) and central (CVOME) retinal vein occlusion. IOP was measured in all patients using rebound tonometer at 7 preset time points perioperatively. Additionally, based on the administered medication, the eyes were classified into three treatment groups, including dexamethasone intravitreal implant (IVO), intravitreal conbercept (IVC), and intravitreal ranibizumab (IVR). To compare IOP values at various time points across groups, we employed one-way ANOVA, independent sample t-test or χ2 test and multivariate logistic regression analysis. RESULTS: Peak IOP values across all groups were observed at 40s, and 5min after intravitreal injection. Statistical differences in IOP were detected at the 5min among the 7 indication groups (F=2.50, P=0.029). When examing the impact of medications, the IVO group exhibited lower average IOP values at both 40s and 5min compared to the IVC and IVR groups (P<0.001; P=0.007). The IOP values at 40s and 5min were significantly higher in BVOME and CVOME group compared to non-retinal vein occlusion-secondary macular edema (RVOME) group (P<0.001). Multivariate logistic regression analysis further confirmed that IOP measurement at 40s was significantly higher in CVOME group than in non-RVOME group (OR=1.64, 95%CI: 1.09-2.47; P=0.018). CONCLUSION: Needle size plays a crucial role in the transient changes of IOP following intravitreal injection. Before administering intravitreal injection to patients with central retinal vein occlusion, it is essential to exclude any underlysing causes of increased IOP.

Is retinal vein occlusion highly associated with an increased risk of myocardial infarction? A systematic review and meta-analysis.

Retinal vein occlusion (RVO) and acute myocardial infarction (MI) are significant vascular events that impact patient health and mortality. Both conditions share common risk factors, such as hypertension, diabetes, and atherosclerosis. This study investigated the potential connection between RVO and MI, particularly among younger individuals, to improve preventive measures and management protocols. A systematic review and meta-analysis were conducted, adhering to the PRISMA and MOOSE guidelines. Multiple databases, including PubMed, Scopus, MEDLINE, ScienceDirect, and ClinicalTrials.gov, were exhaustively searched until August 24, 2024. Studies were selected based on their reports of the association between RVO and MI risk. Quality assessment was performed using the Newcastle-Ottawa Quality Assessment Scale, and data were pooled using a random-effects model with hazard ratios and 95% confidence intervals. Twelve studies comprising 371,817 participants were included. Meta-analysis revealed a pooled hazard ratio of 1.324 (95% CI, 1.238-1.415), indicating a significant association between RVO and increased MI risk (p = 0.0001). Subgroup analysis for central retinal vein occlusion (CRVO) showed a hazard ratio of 1.691 (95% confidence interval [CI] 1.142, 2.502, p = 0.009) with moderate heterogeneity (I2 = 36%), whereas branch retinal vein occlusion (BRVO) yielded a non-significant hazard ratio of 1.167 (95% CI 0.843, 2.106, p = 0.444; I2 = 33%). Publication bias was identified (Egger's test, p = 0.036) and addressed through trim-and-fill adjustment, maintaining statistical significance. Our meta-analysis shows a strong association between CRVO and a 69.1% increased risk of MI, while BRVO shows no significant correlation. Overall, RVO is linked to a 32.4% elevated risk of MI. Despite slight publication bias, adjusted analyses confirm reliability, indicating that improved cardiovascular monitoring for RVO patients, especially those with CRVO, is essential to mitigate MI risk. Not applicable.

Retinal Microvascular Changes in Association with Endothelial Glycocalyx Damage and Arterial Stiffness in Patients with Retinal Vein Occlusion: A Cross-Sectional Study

Background/Objectives: To investigate the potential association between the endothelial dysfunction and arterial stiffness with retinal changes observed through optical coherence tomography (OCT) and OCT-angiography (OCT-A) in patients with retinal vein occlusion (RVO). Methods: Participants in this cross-sectional study were 28 patients with RVO. The demographic and clinical characteristics of all participants were recorded. Comprehensive ophthalmologic examinations were performed, including fundus photography, OCT and OCT-A. Endothelial dysfunction was assessed by measuring the endothelial glycocalyx thickness via the perfused boundary region (PBR5-25). Arterial stiffness was evaluated by measuring the carotid-femoral pulse wave velocity (PWV), the central systolic and diastolic blood pressures (cSBP and cDBP) and the augmentation index (Aix). For each ophthalmological outcome, we generated a saturated linear regression model with demographic and systemic vascular parameters serving as independent variables. Regression coefficients with the corresponding 95% confidence intervals (CIs) were reported. A p value < 0.05 was considered as statistically significant. Results: A 1 m/s increase in PWV was associated with a 0.6% reduction in inferior macular vessel density (VD) (p = 0.050). A 10 mmHg increase in cSBP was associated with a 0.03 mm2 increase in foveal avascular zone (FAZ) area (p = 0.033). A 1% increase in Aix was associated with a 0.005 mm2 increase in FAZ area (p = 0.008). A 1 μm increase in PBR5-25 was associated, on average, with a 4.4% decrease in superior peripapillary VD (p = 0.027). Conclusions: In patients with RVO, structural and microvascular retinal parameters were significantly associated with markers of endothelial dysfunction and arterial stiffness.

Influence of Aflibercept on Choroidal Blood Flow and Thickness in Branch Retinal Vein Occlusion: A Six-Month Follow-Up Study

Influence of Aflibercept on Choroidal Blood Flow and Thickness in Branch Retinal Vein Occlusion: A Six-Month Follow-Up Study

Blue light reflectance imaging in non-perfusion areas detection: insights from multimodal analysis

DesignA retrospective, cross-sectional image analysis using a convenience sample.SubjectsFive cases selected based on the availability of comprehensive imaging data.MethodsThis study involved a retrospective review of images from five cases, focusing on the use of retinal monochromatic blue light reflectance (BLR) imaging to detect non-perfusion areas. Two cases of sickle-cell retinopathy demonstrated peripheral retinal non-perfusion identified through widefield fluorescein angiography. Three other cases—one with branch retinal vein occlusion, one with branch retinal artery occlusion, and one presenting paracentral acute middle maculopathy showed focal macular non-perfusion detected by structural OCT and OCTA. The areas of nonperfused retinal tissue, confirmed by fluorescein angiography, OCT, and OCTA, were then correlated with findings from the BLR image. This correlation aimed to identify any potential associations between these imaging modalities.Main outcome measuresEnhance understanding of the utilization of retinal monochromatic BLR images as a non-perfusion biomarker.ResultsThe perfusion defects identified through fluorescein angiography were qualitatively correlated with hypo-reflective regions observed in the BLR images. A notable correlation was also observed between the OCTA deep capillary plexus findings and the BLR images. Additionally, areas of retinal thinning identified on structural OCT thickness maps corresponded with the hypo-reflective regions in the BLR images. This indicates the potential of BLR in identifying non-perfused retinal areas.ConclusionsThis study reinforces the evidence, through OCT, OCTA, and angiographic correlation, that the BLR can effectively identify areas of retinal non-perfusion in a non-invasive manner. Further research is warranted to assess the method’s sensitivity, specificity, and limitations. While the interaction of blue light with the retina, leading to specular reflections and scattering, is established, this research represents a pioneering effort in suggesting which specific retinal structures may be implicated in this phenomenon. This novel insight opens avenues for deeper exploration into the underlying mechanisms and potential clinical applications of utilizing the BLR imaging technique for assessing retinal vascular abnormalities.

Safety and Efficiency of Anti-VEGF with Dexamethasone Intravitreal Implant for Non-Ischemic Retinal Vein Occlusion: A Prospective, Case-controlled, Cohort Study.

This study aimed to assess the efficacy and safety of anti-VEGF combined with dexamethasone implant for the retinal vein occlusion patients with macular edema. In this prospective, case-controlled, cohort clinical trial (Register ID: ChiCTR2400080048), patients with non-ischemic retinal vein occlusion were enrolled from the Sanmenxia Central Hospital from August 2020 to April 2023. The patients were randomized into two groups. All the patients received ranibizumab intravitreal injection in the first 3 consecutive months. For the ranibizumab group, anti-VEGF injections were as needed thereafter in case of recurrence of macular edema; For the combination group, the patients received an intravitreal dexamethasone implant injection at 15 days after the first ranibizumab injection. The primary outcome measurements were improvement in best corrected visual acuity (BCVA) and reduction in central macular thickness (CMT). The secondary outcomes were recurrence of macular edema, number of intravitreal injections, and injection interval. Safety profiles were also recorded. A total of 124 patients were included, of which 73 patients completed all follow-ups. Both the ranibizumab monotherapy and the combination therapy significantly improved BCVA at all time points, compared to the baseline. The combined group achieved more BCVA improvement in 3 months, 6 months, and 12 months, compared to the ranibizumab alone group. Compared to the baseline, both groups achieved significant reductions in CMT at all follow-ups. However, the combination group showed more CMT reduction at 1 week post injection, compared to the ranibizumab group. The combination group had a significantly longer injection interval, lower injection time, and recurrence of macular edema. Ocular hypertension was the most common adverse events. Lastly, intraocular pressure was all well controlled by 1-3 glaucoma medications without surgical intervention. The combination therapy could significantly improve the BCVA and reduce the CMT with a good safety profile.

Retinal vascular events and relationship to CANCER development

BackgroundCentral retinal vein occlusion (CRVO) is a frequent and clinically relevant vascular pathology. The main risk factors are the same as systemic cardiovascular risk factors, but recently other significant risk factors have been studied. The aim of this study is to analyse the risk factors for retinal venous thrombosis and their relationship with the development of cancer. Methods710 patients with retinal vascular pathology were included, of whom 527 had suffered retinal venous thrombosis. Patients were followed up in internal medicine outpatient clinics between September 24, 1999, and April 30, 2022. The incidence of cancer during that time was collected. ResultsOf 527 patients evaluated, 448 (86.7 %) presented cardiovascular risk factors, and 89 (17.2 %) developed some neoplasm, being the most frequent: prostate (19.1 %), colon (16.9 %), skin (12.4 %), breast (9.0 %). Retinal venous thrombosis was related to the development of neoplasms during follow-up time (Log Rank = 5.28, p = 0.022; Breslow = 4.84, p = 0.028). Other significant factors were age above the median, smoking, HbA1c levels, and homocysteine levels higher than the median, and cholesterol and LDL-Cholesterol lower than the median. Age above the median (p < 0.001), smoking (p = 0.003) and levels of cholesterol below the median (p = 0.026) were independently related to the development of neoplasms. ConclusionsRetinal venous thrombosis is associated with the development of cancer. Other factors related to its development have been identified. If this is confirmed, the implications for the diagnosis, control, and treatment of these patients should be evaluated.

Prognostic algorithm for risk assessment of retinal vein occlusion under geomagnetic perturbations

Aim. To develop a screening and prognostic algorithm for assessing the risk of retinal vein occlusion in patients with arterial hypertension under the conditions of geomagnetic disturbances. Material and methods. In total, 1512 patients with arterial hypertension of 1–4 stages were examined. Within the period of three years, 391 patients developed retinal venous occlusions. The parameters of systemic and regional hemodynamics in these patients, as well as ocular microcirculatory function, were compared both in a magnetically calm environment and during geomagnetic disturbances. To simulate the response of microcirculatory bed to stress, a functional pharmacological instillation test with a 10% Irifrin solution was performed. To assess the geomagnetic situation, the Кр index was used, which objectively characterizes fluctuations of the Earth’s magnetic field over a 3h time interval. The International Classification of Кр values was used. Results. For statistical analysis, 78 studied signs of systemic, regional hemodynamics, and microcirculation were selected. The prognostic significance of 30 studied signs was revealed. A training group (1434 people) and an examination group (78 people) were formed. Based on the training group, a predictive algorithm was formed. A number of regularities were established, which can be used to create a system for risk assessment of retinal vein thrombosis during geomagnetic disturbances in patients with hypertension. To determine the risk of retinal vein occlusion, a coefficient was developed. The algorithm showed the sensitivity and specificity of 89% and 94%, respectively. Conclusion. A prognostic algorithm with high sensitivity and specificity for assessing the risk of occlusive lesions of the retinal veins during geomagnetic disturbances in patients with arterial hypertension is proposed.

A rare case of systemic lupus erythematosus presenting with concurrent myocarditis, central retinal vein occlusion, and deep vein thrombosis.

Although systemic lupus erythematosus may present with broad and variable symptoms, the rare and atypical combined presentation of central retinal vein occlusion, myocarditis, and deep vein thrombosis poses a diagnostic challenge and highlights the need for a comprehensive diagnostic approach. Early diagnosis and prompt treatment help mitigate disease morbidity and mortality, and emphasize the importance of heightened clinical suspicion in complex presentations.

Central retinal vein occlusion: a case report

Tujuan pengobatan CVRO adalah untuk mencegah kerusakan lebih lanjut pada retina dan meningkatkan penglihatan. Kehilangan penglihatan dapat terjadi di satu atau kedua mata, dan dapat terjadi secara tiba-tiba atau bertahap, memengaruhi seluruh lapangan pandang atau hanya sebagian. Nyeri dirasakan tidak terlalu mengganggu dan bertahan 3 hari setelah onset. Pandangan terganggu dirasakan awalnya hanya sedikit pada bagian dekat hidung lalu semakin lama meluas ke bagian tengah hingga membuat pasien kesulitan untuk melihat benda menggunakan dengan mata kanan. Kontrol diabetes dan tekanan darah dapat membantu mencegah kerusakan pembuluh darah di retina. Berhenti merokok dapat membantu melindungi pembuluh darah dari kerusakan. Deteksi dini CVRO sangat penting untuk meningkatkan peluang pemulihan penglihatan. Jika Anda mengalami gejala CVRO, segera konsultasikan dengan dokter mata. Pemeriksaan mata rutin juga penting untuk mendeteksi CVRO pada tahap awal, sebelum gejala muncul. Oklusi vena retina sentral merupakan kondisi serius yang dapat menyebabkan kehilangan penglihatan. Deteksi dini dan pengobatan yang tepat sangat penting untuk meningkatkan peluang pemulihan penglihatan

Tortuous conjunctival vessels and central retinal vein occlusion in spontaneous dural arteriovenous fistula.

Tortuous conjunctival vessels and central retinal vein occlusion in spontaneous dural arteriovenous fistula.

Dexamethasone implantation causing iatrogenic lens injury: a review of literature with case series

Aims: In this study, three cases of iatrogenic lens injuries during Dexamethasone (DXM) implantation will be discussed and current approaches will be reviewed with the literature. Methods: Three patients with iatrogenic lens injury during DXM implantation were evaluated retrospectively. Results: The three patients underwent DXM implantation for cystoid macular edema with central retinal vein occlusion and one patient for EALES disease. The surgical intervention was performed in all three patients in conjunction with cataract surgery. Intraocular lens implanted into the sulcus in all patients. The DXM could be directed to the vitreous in two patients with intact anterior hyaloid, while the other patient underwent anterior vitrectomy and DXM explanation. Anti-vascular endothelial growth factor was injected in the patient who could not implant DXM. The lens was stable in all patients in postoperative controls. There was a decrease in macular thickness at follow-up. Conclusion: Dexamethasone implant is a slow-release tablet for macular edema due to retinal vein occlusion, diabetic retinopathy and non-infectious uveitis. Lens injury during dexamethasone implantation is a rare complication. In our series, the implant occluded the visual axis and most of it was in the lens, managed with cataract surgery. If possible, DXM should be directed to the vitreous, if not, treatment modalities should be specificized on a patient-by-patient basis.

Prognosis and factors related to anti-VEGF therapy in patients with retinal vein occlusion and concomitant carotid artery disease

To evaluate the prognosis and influencing factors of retinal vein occlusion (RVO) in patients with concomitant carotid artery disease receiving anti-vascular endothelial growth factor (VEGF) treatment. Patients diagnosed with RVO and receiving anti-VEGF treatment were included. Eye and clinical data were collected. The patients were divided into a group with concomitant carotid artery disease (Group A) and a group without concomitant carotid artery disease (Group B). The risk factors affecting the visual prognosis of RVO patients with concomitant carotid artery disease were analyzed. Among 177 eligible patients with RVO, 101 had concomitant carotid artery disease (Group A), while 76 did not (Group B). Group A had a significantly lower treatment effectiveness rate than Group B (P < 0.001). The age and platelet distribution width of Group A were significantly higher than Group B (P < 0.001). Multivariate logistic regression analysis showed that baseline best-corrected visual acuity (BCVA), disorganization of retinal inner layers (DRIL), external limiting membrane (ELM) disruption, and red blood cell distribution width (RDW) were significantly associated with the posttreatment visual prognosis of RVO patients with concomitant carotid artery disease(P < 0.05). RVO patients with concomitant carotid artery disease had a significantly lower treatment effectiveness rate than RVO patients without carotid artery disease. The poor baseline BCVA, DRIL, ELM disruption, and a greater RDW are risk factors for low anti-VEGF treatment efficacy among RVO patients with concomitant carotid artery disease.

New risk factors and predictions of the development of retinal vein occlusion after cardiac surgeries with the use of artificial circulation

Background. Cardiovascular diseases are one of the risk factors for the development of retinal vein occlusion (RVO). Cardiac interventions with artificial circulation (AC) can be associated with perioperative complications, including retinal vessel occlusion. The actual task of modern ophthalmology is to determine the frequency of retinal vessel occlusions, clinical features, risk factors, the role of markers of inflammation and endothelial dysfunction in RVO in patients with cardiovascular diseases after surgeries with artificial circulation. The purpose of the study was to investigate new risk factors and predict the development of retinal vein occlusions after cardiac surgeries using artificial circulation. Materials and methods. Three hundred and ninety-four patients (638 eyes) were under observation. Of them, 220 people (405 eyes) had cardiovascular diseases and underwent heart surgeries with the use of AC. In these patients, we determined the nature, frequency and features of the development and clinical course of RVO after cardiac surgery with AC in the early and late periods of observation (3 and 6 months). Also, a study was conducted of 174 patients (233 eyes) with cardiovascular diseases who underwent cardiac surgeries with AC, and the serum levels of markers of inflammation (IL-6 and IL-8) and endothelial dysfunction (VE-cadherin) were determined before and after operations depending on the time of RVO occurrence. The main group included 126 patients (137 eyes) who were diagnosed with occlusion of the central retinal vein (CRV) or its branches after surgery with AC; the comparison group — 43 patients (86 eyes) who did not have retinal vein occlusion during the entire observation period; the control group — 5 patients (10 eyes) who had the same degree and duration of the underlying disease, indications for surgery with AC, but were examined before the operation, and within 180 days after it, and did not have RVO. The patients were examined by an ophthalmologist 2, 7, 30, 60, 90 and 180 days after cardiac surgery. The content of IL-6, IL-8 and VE-cadherin in blood serum was determined by the enzyme immunoassay (Bender MedSystems, Austria). Statistical data were processed using the Statistica 10 program (StatSoft Inc., USA), regression analysis was performed with the help of the GLZ software package. Results. As a result of the research, it was found that the frequency of retinal vein occlusions after cardiac surgeries with the use of artificial circulation was 0.99 % on the 2nd day, 3.95 % on the 7th day, 10.2 % after 3 months, 1.4 % after 6 months. The conducted discriminant analysis showed that the type of occlusion was determined by age, lower visual acuity, and the order of occlusion of the CRV branches. An increase in the macular volume of the retina was also significant, reflecting the development of macular edema. The regression model for predicting the type of occlusion based on visual acuity, the order of occlusion of the CRV branches and age had a prediction accuracy of 82.5 %. Cardiac surgeries with the use of AC caused an increase in interleukin content in the early period (IL-6 on days 2 and 7, and IL-8 — up to day 30), while the content of VE-cadherin was slightly increased during almost the entire observation period. In the presence of RVO, IL-6 content was significantly higher at all stages of occlusion development, IL-8 content — up to 30 days, and VE-cadherin content — mostly after 7 days. Regression analysis showed that after 1–2 days, the occurrence of RVO was directly related to the content of IL-6 and IL-8 in the blood, on days 3–7 — to the content of only IL-8, on days 8–30 — to the content of all markers, and later — to the content of IL-6 and VE-cadherin. The prediction accuracy for the presence or absence of RVO in the corresponding term according to the calculated regression models is at least 78 % (p &lt; 0.001), which proves the influence of markers on the development of RVO. Conclusions. The conducted study shows the importance of acute inflammation and endothelial dysfunction in the occurrence of RVO when using AC, which justifies the use of preventive measures in the early stages of limiting the activity of the inflammatory process, in the later stages — preventing the development of endothelial dysfunction.

Occlusive lesions of retinal vessels: etiological and patogenetic factors

Background. Vascular pathology of the organ of vision is one of the most urgent problems of ophthalmology, as it is the main cause of vision loss and vision loss. Retinal vein occlusion ranks second after diabetic retinopathy in the world among vascular causes of vision loss. In a significant risk group for the occurrence of occlusions of the retinal vessels are patients with cardiovascular diseases. Today, treatment of patients with coronary heart disease and patho­logy of heart valves is impossible without surgical interventions, most of which require the use of artificial circulation (AC). During the operation of the AC due to prolonged hypothermia, hemodilution, prolonged hypotension, anemia, development of ophthalmologic complications in the early postoperative period is possible. The purpose of the study was to investigate etiological and pathogenetic factors of occlusive lesions of retinal vessels. Mate­rials and methods. The search for sources of Ukrainian and foreign literature for the ana­lytical review was conducted keywords using the open medical scientific database PubMed (USA). At the first stage, 211 sources were selected, of which 66 were selected for this article. Results. Occlusion of the central retinal vein (CVO) deve­lops in 214 people per 100,000 population, mainly in people over 65 years of age. The frequency of branh retinal vein occlusions (BRVO) is 67.2%, of which 82.4% is a occlusion of the superior temporal branch. The main risk factors of CVO are age, hypertension, diabetes, atherosclerosis, glaucoma, coronary heart disease. A small number of sources are found in the literature regarding complications from the organ of vision in patients after cardiac surgery with AC such us thromboembolism of retinal vessels, optic ischemic optic neuropathy, retinal ischemia, optic nerve atrophy, retinal detachment, proliferative vitreoretinopathy. The authors' research showed a multiple increase in blood markers of endothelial dysfunction, including vascular endothelial cadherin (VE-cadherin, VE-C) after surgery. Conclusions. Diseases of the organ of vision due to general or local blood circulation disorders account for 10 to 28%, 2.6% of which lead to blindness. There is a relationship between occlusive lesions of retinal veins and cardiovascular diseases. The main reasons for the development of retinal vein occlusion after cardiac surgery with coronary artery disease are acute inflammation occurring during and immediately after surgery and endothelial dysfunction.

Dexamethasone implant for refractory macular edema secondary to diabetic retinopathy and retinal vein occlusion.

To evaluate the efficacy, timing of retreatment and safety of dexamethasone (DEX) implant on macular edema (ME) secondary to diabetic retinopathy (DME) and retinal vein occlusion (RVO-ME) patients who were refractory to anti-vascular endothelial growth factor (VEGF) treatment. This retrospective study included 37 eyes received at least one DEX implant treatment for DME or RVO-ME between January 1, 2019, and January 1, 2023. These refractory DME and RVO-ME cases received at least 5 anti-VEGF injections and failure to gain more than 5 letters or a significant reduction in central retinal thickness (CRT). The best corrected visual acuity (BCVA) and CRT were measured at baseline, and at 1, 3, 4 and 6mo post-DEX implant injection. Adverse events such as elevated intraocular pressure (IOP) and cataract were recorded. For RVO cases (n=22), there was a significant increase in BCVA from 0.27±0.19 to 0.35±0.20 at 6mo post-DEX injection (P<0.05) and CRT decreased from 472.1±90.6 to 240.5±39.0 µm at 6mo (P<0.0001). DME cases (n=15) experienced an improvement in BCVA from 0.26±0.15 to 0.43±0.20 at 6mo post-DEX implant injection (P=0.0098), with CRT reducing from 445.7±55.7 to 271.7±34.1 µm at 6mo (P<0.0001). Elevated IOP occurred in 45.9% of patients but was well-controlled with topical medications. No cases of cataract or other adverse events were reported. DEX implants effectively improve BCVA and reduce CRT in refractory DME and RVO-ME. Further research with larger cohorts and longer follow-up periods is needed to confirm these findings and assess long-term outcomes.

Suprachoroidal Triamcinolone Acetonide Injection to Treat Macular Edema: A Review.

Purpose: To review the available literature on the efficacy and safety of suprachoroidal triamcinolone acetonide for the treatment of chorioretinal diseases. Methods: The results of the literature review were analyzed. Results: This review included 17 clinical studies of triamcinolone acetonide administration (6, diabetic macular edema; 1, central retinal vein occlusion [RVO]; 2, branch RVO; 7, noninfectious uveitis; 1, cystoid macular edema after cataract surgery). Overall, suprachoroidal triamcinolone acetonide was shown to be effective in decreasing macular thickness and increasing visual (VA) in cases of chorioretinal diseases. The most frequently reported adverse events were eye pain, cataract, and increased intraocular pressure. Conclusions: Except for 3 sufficiently powered trials of suprachoroidal triamcinolone acetonide for macular edema associated with noninfectious uveitis, most other studies were clinical trials with small samples. These studies found that suprachoroidal triamcinolone acetonide has a satisfactory safety and efficacy profile. Further research with sufficiently large samples is required to confirm the potential role of suprachoroidal triamcinolone acetonide in retinal diseases.

AI-based 3D analysis of retinal vasculature associated with retinal diseases using OCT angiography

Retinal vasculature is the only vascular system in the human body that can be observed in a non-invasive manner, with a phenotype associated with a wide range of ocular, cerebral, and cardiovascular diseases. OCT and OCT angiography (OCTA) provide powerful imaging methods to visualize the three-dimensional morphological and functional information of the retina. In this study, based on OCT and OCTA multimodal inputs, a multitask convolutional neural network model was built to realize 3D segmentation of retinal blood vessels and disease classification for different retinal diseases, overcoming the limitations of existing methods that can only perform 2D analysis of OCTA. Two hundred thirty sets of OCT and OCTA data from 109 patients, including 138,000 cross-sectional images in normal and diseased eyes (age-related macular degeneration, retinal vein occlusion, and central serous chorioretinopathy), were collected from four commercial OCT systems for model training, validation, and testing. Experimental results verified that the proposed method was able to achieve a DICE coefficient of 0.956 for 3D segmentation of blood vessels and an accuracy of 91.49% for disease classification, and further enabled us to evaluate the 3D reconstruction of retinal vessels, explore the interlayer connections of superficial and deep vasculatures, and reveal the 3D quantitative vessel characteristics in different retinal diseases.

Retinal Vein Occlusion

This animated video article provides an overview of the pathogenesis, symptoms, risk factors, and unmet needs in retinal vein occlusion.

Negative impact of internal limiting membrane peeling in vitreous hemorrhage secondary to retinal vein occlusion with macular ischemia.

To investigate the effect of internal limiting membrane (ILM) peeling on visual outcomes and postoperative epiretinal membrane (ERM) after pars plana vitrectomy (PPV) for vitreous hemorrhage (VH) associated with retinal vein occlusion (RVO) with various degrees of macular ischemia. We compared the outcomes of eyes that underwent vitrectomy with and without ILM peeling from 2012 to 2021 with a minimum follow-up of 6months. 112 charts were analyzed, and 51 eyes met the inclusion criteria. There were 19 eyes with ILM peeling and 32 eyes with non-ILM peeling. Baseline characteristics did not differ significantly. The mean postoperative visual acuity significantly improved at 6months compared with the mean preoperative visual acuity (P < 0.001). Visual improvement was significantly greater in the non-ILM peeling group(P < 0.05). Without ischemia within the arcade, there was no significant difference in the visual improvement. In patients with ischemia, the visual improvement in the ILM peeling group was significantly worse than that in the non-ILM peeling group. The incidence of postoperative ERM was significantly higher in the non-ILM peeling; however, there was no significant change in postoperative vision due to the presence of ERM. Vitrectomy either with or without ILM peeling results in visual improvement in patients with VH associated with RVO; however, it should be uniformly avoiding ILM peeling in cases with pre-existing macular ischemia, as it may significantly lead to a deterioration in visual outcomes. What is known Pars plana vitrectomy is effective for visual improvement in vitreous hemorrhage associated with retinal vein occlusion. The incidence of postoperative epiretinal membrane is variable depending on the surgical approach. What is new Avoiding ILM peeling in cases of macular ischemia during vitrectomy is crucial for better visual outcomes. Despite higher rates of epiretinal membrane post-surgery in non-ILM peeled eyes, their visual outcomes remain superior to those with ILM peeling.