Type 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.

Disparities in Retinal Vein Occlusion Presentation and Initiation of Anti-VEGF Therapy: An Academy IRIS® Registry Analysis

Investigate disparities in retinal vein occlusion (RVO) presentation and initiation of anti-VEGF treatment. Retrospective cohort study. Patients in the American Academy of Ophthalmology IRIS® (Intelligent Research in Sight) Registry database (2015-2021) with branch or central RVO and macular edema (ME). The association of demographic characteristics and presenting visual acuity (VA) with anti-VEGF treatment initiation were quantified using multivariable logistic regression. Treatment with ≥ 1 anti-VEGF injection within 12 months after RVO diagnosis. A total of 304 558 eligible patients with RVO and ME were identified. Age at presentation varied by race, ethnicity, sex, and RVO type (all P values < 0.001). Within the first year after RVO presentation, 192 602 (63.2%) patients received ≥ 1 anti-VEGF injection. In a multivariable regression model adjusting for relevant covariates, female (vs. male) patients had lower odds of receiving injections (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.93-0.96; P < 0.0001) as did Black/African American (vs. White) patients (OR, 0.90; 95% CI, 0.88-0.92; P < 0.0001) and Asian (vs. White) patients (OR, 0.95; 95% CI, 0.91-0.99; P= 0.02), whereas older patients (vs. patients aged < 51 years) had higher odds (61-70 years: OR, 1.20; 95% CI, 1.16-1.24; 71-80 years: OR, 1.20; 95% CI, 1.16-1.24; > 80 years: OR, 1.15; 95% CI, 1.11-1.18; all P values < 0.0001). Hispanic (vs. non-Hispanic) patients had a small increased odds of treatment initiation (OR, 1.08; 95% CI, 1.04-1.11; P < 0.0001). Results were similar in the subset of 226 143 patients with VA data. In this subset, patients with presenting VA < 20/40 to 20/200 were most frequently treated in the first year after diagnosis (∼ 70%) and patients with light perception/no light perception (LP-NLP) vision or VA of 20/20 or better were treated least frequently (36.9% and 41.9%, respectively). In this large national clinical registry, 37% of RVO patients with ME had no anti-VEGF treatment documented in the first year after diagnosis. Black/African American, Asian, and female patients and patients with VA of LP-NLP were least likely to receive treatment. Awareness of this undertreatment and these disparities highlight the need for initiatives to ensure all RVO patients receive timely anti-VEGF injections for optimized visual outcomes. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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.

Automatic Diagnosis of Different Types of Retinal Vein Occlusion Based on Fundus Images

Retinal vein occlusion (RVO) is the second common cause of blindness following diabetic retinopathy. The manual screening of fundus images to detect RVO is time consuming. Deep-learning techniques have been used for screening RVO due to their outstanding performance in many applications. However, unlike other images, medical images have smaller lesions, which require a more elaborate approach. To provide patients with an accurate diagnosis, followed by timely and effective treatment, we developed an intelligent method for automatic RVO screening on fundus images. Swin Transformer learns the hierarchy of low-to high-level features like the convolutional neural network. However, Swin Transformer extracts features from fundus images through attention modules, which pay more attention to the interrelationship between the features and each other. The model is more universal, does not rely entirely on the data itself, and focuses not only on local information but has a diffusion mechanism from local to global. To suppress overfitting, we adopt a regularization strategy, label smoothing, which uses one-hot to add noise to reduce the weight of the categories of true sample labels when calculating the loss function. The choice of different models using a 5-fold cross-validation on our own datasets indicates that Swin Transformer performs better. The accuracy of classifying all datasets is 98.75 ± 0.000, and the accuracy of identifying MRVO, CRVO, BRVO, and normal, using the method proposed in the paper, is 94.49 ± 0.094, 99.98 ± 0.015, 98.88 ± 0.08, and 99.42 ± 0.012, respectively. The method will be useful to diagnose RVO and help decide grade through fundus images, which has the potency to provide patients with further diagnosis and treatment.

Evaluation of Cystoid Macular Edema in Patients with Retinal Vein Occlusion, Makkah Eye Hospital, Aden, Yemen

Background: Cystoid macular edema (CMO) represents a common pathologic sequel of the retina. This study aimed to study the occurrence of cystoid macular edema in patients with retinal vein occlusion. Materials and methods: We reviewed retrospectively the medical records of 54 retinal vein occlusion patients in Makkah eye hospital in Aden, from January to December 2021. The collected data analyzed by SPSS version 22. Chi-square test was used and a p-value less than 0.05 was determined as statistically significant. Results: The total study patients with retinal vein occlusion (RVO) were 54, (males 63.0% and females 37.0%). The mean age was 58.2 ± 12.7 years. The most side involvement of branch retinal vein occlusions (BRVO) was in the right eyes with (25%) and of central retinal vein occlusions (CRVO) in (30%), (p &gt; 0.05).The total number of eyes with RVO was 60 eyes, of which 26 eyes were with BRVO and 34 eyes with CRVO. In eyes with BRVO (35.0%) developed CMO while in eyes affected by CRVO, (31.7%), (p &lt; 0.05). We found higher intra-ocular pressure (IOP) &gt; 21 mmHg in CRVO with (18.4%) while in BRVO were in (8.3%), (p &gt; 0.05).There was a positive correlation between hypertension and RVO (P &lt; 0.05) and there was no significant relation in this study between glaucoma and occurrence of RVO (p &gt; 0.05). The visual acuity after receiving the Avastin injections improved in all visual acuity groups. Conclusion: In this study, males were predominant. The CRVO was the commonest type of RVO. Some patients with CRVO and BRVO developed CMO. The relation between values of BRVO and CRVO related to the occurrence of CMO was statistically significant (p &lt; 0.05). Keywords: Evaluation, cystoid macular edema, retinal vein occlusion, Aden, Yemen

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.

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.

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.

ENDOTHELIN-1 AS A RISK FACTOR IN RETINAL VEIN OCCLUSION.

Retinal vein occlusion (RVO) risk factors largely coincide with cardiovascular risk factors. Endothelin-1 (ET-1), the most potent vasoconstrictor with proinflammatory properties, is a known cardiovascular risk factor. In this study, we explore the role of serum ET-1 as a potential risk factor for RVO. Endothelin-1 serum levels were measured in patients with RVO and control subjects. Samples were measured using the sandwich enzyme-linked immunosorbent assay for the quantitative determination of human big endothelin-1 (Biomedica Group, Austria). The study consisted of 147 RVO patients and 150 control subjects. Median serum ET-1 was significantly higher in RVO patients (0.26 pmol/L; range, 0.19-0.37 pmol/L) compared with control subjects (0.10 pmol/L; range, 0.05-0.22 pmol/L) (P < 0.0001) independent of the occlusion site. The difference remained significant after adjusting for arterial hypertension, diabetes mellitus, history of stroke, history of myocardial infarction, history of venous thromboembolism, glomerular filtration rate, and c-reactive protein. In conclusion, our results suggest that ET-1 is a potential risk factor for all types of RVO.

Clinical therapeutic effects of intravitreal injection of Conbercept for macular edema in different types of retinal vein occlusion

Clinical therapeutic effects of intravitreal injection of Conbercept for macular edema in different types of retinal vein occlusion

OPTICAL COHERENT TOMOGRAPHY IN DIAGNOSIS OF ACUTE DISORDERS OF VENOUS BLOOD CIRCULATION IN THE RETINA AND THEIR COMPLICATIONS

A comprehensive ophthalmological examination of patients with acute disorders of venous blood circulation in the retina was carried out using a new, modern, non-contact and highly accurate method of diagnosing ophthalmological diseases – optical coherent tomography. The features of optical coherent tomography in patients with different types of acute disorders of venous blood circulation in the retina are described.&#x0D; Comprehensive examination of such patients using traditional ophthalmological methods, biomicroophthalmoscopy, retinal photography using a fundus camera, fluorescent angiography, optical coherent tomography provides early diagnosis of macular edema and ischemic retinal zones.&#x0D; We examined 62 patients with retinal vein occlusion. Ischemic type of retinal vein occlusion was diagnosed in 30 patients and non-ischemic type in 32 patients.&#x0D; The average age of patients with ischemic thrombosis was 63.5 years. The initial visual acuity of the affected eye patients was low: 0.01-0.05 (20 patients with ischemic thrombosis) and 0.05-0.1 (10 patients with ischemic thrombosis) depending on the lesion of the macular retina zone.&#x0D; On fluorescent angiograms of patients with ischemic retinal central vein thrombosis, there was a considerable elongation of retinal circulation time, asymmetry in contrasting the branches of the retinal central vein. The main sign of ischemic thrombosis was extensive hypo- and non-fluorescence retinal regions. In the later phases, hyperfluorescence of the optic disc and the macular region were recorded.&#x0D; In patients with ischemic type of acute disorders of venous circulation in the retina, a thickening of the retina is detected on the optical coherent tomography, mainly due to diffuse and cystic macular edema, as well as exudative detachment of the neuroepithelium. Retinal thinning areas on optical coherent tomography responded to areas of capillary neperfusion.&#x0D; The average age of non-ischemic thrombosis patients was 59.2 years. Non-ischemic thrombosis patients showed relatively high visual acuity. Initial visual acuity of 0.3 and above was found in 23 patients with non-ischemic thrombosis; 0.1 - 0.3 - in 5 patients; less than 0.1 - in 4 patients. Macular edema was one of the main reasons for the significant loss of vision in such patients.&#x0D; On fluorescent angiograms of non-ischemic thrombosis patients, an increase in the time of venous perfusion was recorded, the time of contrasting arteries was in line with normal indicators. In the arterial-venous phase, hyperfluorescence of retinal veins, extraction of large vessels, dilation of capillaries and veins were detected. A hyperfluorescence of the optic disc, the macular region of the retina, has been detected as a result of edema of optic disc and the macular region of the retina. There were no areas of long capillary neperfusion and no signs of retinal neovascularization in non-ischemic thrombosis patients.&#x0D; We have not found extensive areas of retinal thinning in patients with non-ischemic type of acute disorders of venous circulation in retina on optical coherent tomography. A slight thickening of the macular region with no change in retinal architecture has been detected in 5 patients with non-dischemical type of thrombosis&#x0D; This approach makes it possible to predict the course of the disease and to prescribe appropriate treatment to prevent the neovascularization of the retina and the possible development of secondary neovascular glaucoma.

Hyperreflectivity of Inner Retinal Layers as a Quantitative Parameter of Ischemic Damage in Acute Retinal Vein Occlusion (RVO): An Optical Coherence Tomography Study.

PurposeTo investigate the reflectivity changes of inner retinal layers in acute retinal vein occlusion (RVO) on spectral-domain optical coherence tomography (SD-OCT) and to correlate these values with other known parameters of acute ischemic damage.Patients and MethodsIn this retrospective and observational case series, 230 eyes from 115 patients with acute RVO (central or branch) were categorized as ischemic or non-ischemic depending on fluorescein angiography (FA) images at baseline. Thickness and reflectivity of selected retinal layers were measured from SD-OCT images at baseline. Reflectivity values were correlated with other parameters of acute ischemic damage (best-corrected visual acuity (BCVA), retinal thickness, extent of macular edema, ischemic area on fluorescein angiography). The data were compared with contralateral eyes (controls). Prominent middle limiting membrane sign (p-MLM) was also registered.ResultsRVO reflectivity values differed significantly in all retinal layers compared to controls (P<0.001). Ischemic RVO eyes had higher optical intensity values for the innermost retinal layer (IMRL; P=0.008) and inner retinal layer (P=0.019) compared to non-ischemic cases. For all RVO eyes as well as central RVO, severity parameters like BCVA, central and total retinal thickness showed a strong correlation with the IMRL reflectivity. In branch RVO, BCVA remained significantly correlated with the IMRL reflectivity, while the thickness values showed significant correlation only for central foveal thickness in non-ischemic branch RVO type. The p-MLM was seen on OCT in 94% of the ischemic and in 66% of the non-ischemic RVO cases.ConclusionAcute RVO leads to increased reflectivity of inner retinal layers with significantly higher values in the ischemic vs non-ischemic type. Increased inner retinal layers’ reflectivity correlated significantly with BCVA, retinal thickness of separate retinal layers, as well as ischemic area on FA. Quantitative non-invasive measurement of inner retinal layers’ reflectivity might be used to determine the extent of acute ischemic retinal damage in RVO.

Assessment of risk factors, central foveal thickness, visual acuity outcome and therapeutic approach in retinal vein occlusion patients of different age groups: a retrospective record based study

Background: This study was conducted to investigate associated systemic diseases, other risk factors, visual prognosis, treatment approach and central foveal thickness in retinal vein occlusion patients of different age groups.Methods: This single centre, retrospective record based hospital study included patients with retinal vein occlusion presenting to ophthalmic department. All the records of 30 patients were reviewed and data was abstracted and analysed. Initial and final clinical parameters e.g. visual acuity, central foveal thickness, age-group distribution, risk factors, therapeutic approach were analysed.Results: Out of 30 patients, 19 patients were of age-group &gt;50 years and 11 were &lt;50 years. In present study, most common type of retinal vein occlusion (RVO) was ST- BRVO in both the groups. Most common association of RVO in group &gt;50 years was hypertension (84%), and &lt;50 years was hypertension (27.3%), raised lipid level (TG, cholesterol) (27%) and raised serum homocysteine. Patients with uncontrolled DM and hypertension (in our study, 2 patients) required multiple injections even after 4 months of follow-up. Age-group &lt;50 years had better visual acuity and central foveal thickness at initial and final presentation. Raised serum homocysteine level associated with RVO in age-group &lt;50 years (27.3%) versus age-group &gt;50 years (5%).Conclusions: Patients with good control of systemic disorders with RVO shows significantly improved (p value&lt;0.05) visual acuity and central foveal thickness, in both the age-groups. Patients of age group &gt;50 years were more associated with systemic disorder e.g., hypertension and DM. Patients of age group &lt;50 years were more associated with medical condition e.g. hyperlipidemia, raised serum homocysteine. In present study, single patient in age-group &lt;50 years was associated only with sudden and severe dehydration.

Ranibizumab Pro Re nata versus Dexamethasone in the Management of Ischemic Retinal Vein Occlusion: Post-hoc Analysis from the COMRADE Trials

ABSTRACTPurpose: To compare ischemia-related clinical outcomes in patients treated with either ranibizumab pro re nata (PRN) or single dexamethasone implant in the Branch Retinal Vein Occlusion (COMRADE-B) or Central Retinal Vein Occlusion (COMRADE-C) trials.Methods: A post-hoc analysis of the Phase IIIb, 6-month, multicenter, double-masked, randomized, COMRADE-B and COMRADE-C trials. Change over 6 months in retinal ischemia status (central avascular [CA] zone and peripheral nonperfusion [PNP]), mean best-corrected visual acuity (BCVA), the development of shunt vessels and neovascularization, and frequency of laser therapy were assessed in retinal vein occlusion (RVO) patients treated with either ranibizumab 0.5 mg PRN or single dexamethasone 0.7 mg implant, as per European labels, in the COMRADE-B (N = 244; ranibizumab, 126, dexamethasone, 118) or COMRADE-C (N = 243; ranibizumab, 124, dexamethasone, 119) trials. BCVA progression in ischemic vs. non-ischemic patients based on the ischemia assessment at month 6 was carried out.Results: Visual acuity (VA) gains from baseline to month 6 were higher with ranibizumab than with dexamethasone in both patients with central ischemia and those with peripheral retinal nonperfusion, independent of the type of RVO (branch or central). The presence of CA and PNP had a significant impact on VA gain over 6 months in CRVO patients (p < .0001), while there was no significant impact in BRVO. Ranibizumab was associated with less new ischemia than dexamethasone. Central RVO patients treated with dexamethasone received more laser treatments over the 6 months than those treated with ranibizumab, while there was no difference in the frequency of laser therapy between the branch RVO treatment groups.Conclusions: VA gain over six months in ranibizumab-treated RVO patients is not affected by ischemia, and is associated with less development of new ischemia during the first 6 months of treatment and equal or fewer laser treatments than dexamethasone implant.

Grading of macular perfusion in retinal vein occlusion using en-face swept-source optical coherence tomography angiography: a retrospective observational case series

BackgroundTo evaluate the efficacy of swept –source optical coherence tomography angiography (SS-OCTA) in grading macular perfusion in retinal vein occlusion.MethodsRetrospective observational case series including patients with different types of retinal vein occlusion (RVO). SS-OCTA utilizes OCTARA algorithm to examine the retinal vascular plexuses for the presence of morphological signs of ischemia according to a predetermined grading scheme. The findings were compared with fundus fluorescein angiography (FFA), and swept-source optical coherence tomography (SS-OCT) features. Bivariate correlation, coefficient of determination, and crosstabs procedures were used to calculate inter-variable linear correlation, relative contribution of the tested variables, and multivariate association, respectively.ResultsThe study included 144 eyes of 138 patients. The most common type of RVO was branch retinal vein occlusion (BRVO) (53%). The superficial capillary plexus (SCP) and the deep capillary plexus (DCP) did not correlate with each other in all parameters tested. Increased central macular thickness (CMT) and disrupted retinal outer layers (DROL) were associated with increased severity of ischemia in DCP. Disorganized retinal inner layers (DRIL) correlated significantly with the presence of perifoveal capillary ischemia in the SCP and the DCP. Macular ischemia on FFA correlated with ischemia in the SCP layer only. Increased CMT, DROL and DRIL on SS-OCT, and SCP and DCP ischemia on SS-OCTA contributed significantly to diminished best-corrected visual acuity (BCVA).ConclusionSS-OCTA is more precise in defining the extent and location of maximum ischemic insult following RVO compared to FFA, hence represents a more efficient grader for ischemic damage in the posterior pole. Increased CMT, DRIL, and DROL on SS-OCT, and SCP and DCP ischemia on SS-OCTA are significant predictors of poor visual outcome.

Vitrectomy for macular edema due to retinal vein occlusion.

Purpose: To determine the long-term outcomes of vitrectomy for the macular edema associated with a retinal vein occlusion (RVO).Methods: This was a retrospective, consecutive, interventional case series. The intraoperative procedures included internal limiting membrane peeling, arteriovenous sheathotomy, radial optic neurotomy, and intravitreal triamcinolone acetonide injection at the end of the surgery. The main outcome was the best-corrected visual acuity (BCVA).Results: Eight hundred and fifty-four eyes of 854 patients were studied. The eyes consisted of 602 with branch RVO (BRVO), 74 with hemi-central RVO (hemi-CRVO), 87 with nonischemic central retinal vein occlusion (CRVO), and 91 with ischemic CRVO. The mean follow-up period was 68.6 months with a range of 12 to 262 months. The mean BCVA was significantly improved at the final visit (P<0.0001 to 0.0016). The final BCVA improved in 74.4% of the BRVO eyes, in 58.1% of the hemi-CRVO eyes, in 57.4% of the nonischemic CRVO eyes, and in 51.6% of the ischemic CRVO eyes. Multiple regression analysis showed there was no significant relationship between the intraoperative combined procedures and the final BCVA.Conclusions: The results indicate that the type of RVO is significantly associated with the final BCVA, and vitrectomy is a treatment option to improve and maintain BCVA for a long term.

Loss to Follow-Up in Patients With Retinal Vein Occlusion Undergoing Intravitreal Anti-VEGF Injections.

To identify the proportion of patients with retinal vein occlusion (RVO) with loss to follow-up (LTFU) along with potential risk factors after receiving an intravitreal anti-vascular endothelial growth factor (VEGF) injection. A retrospective review based on billing codes was performed from January 1, 2012, to January 1, 2017. LTFU was defined as no office visit within 12 months following an intravitreal injection. Potential risk factors for LTFU were screened using univariate analysis for inclusion in a final multivariate logistic regression model. A total of 3,400 unique patients with RVO with macular edema met the study inclusion criteria. Of these, 863 patients (25.4%) were LTFU. Rates of LTFU varied based on race / ethnicity, age, RVO type, distance from clinic, insurance status, and regional average adjusted gross income. In the multivariate analysis, patients with LTFU were more likely to be black (odds ratio [OR] = 1.37), Hispanic (OR = 2.37), and living more than 20 miles away from clinic (OR = 1.47). Patients who were 65 to 80 years old (OR = 0.71) and those with branch retinal vein occlusion (OR = 0.70) were less likely to be LTFU. Subgroup analysis showed that patients with baseline visual acuity better than 20/50 were also less likely to be LTFU. Approximately one in four patients did not return for a year or more after receiving an intravitreal injection for RVO. Given the importance of ongoing therapy to prevent vision loss, these "real-world" findings are of significant concern. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:159-166.].

Genetic correlation between Prothrombin G20210A polymorphism and retinal vein occlusion risk.

The aim of this study was to perform an updated meta-analysis to quantitatively investigate the association between G20210A polymorphism of Prothrombin gene and the risk of retinal vein occlusion (RVO), based on the available publications with inconsistent results. We utilized the Stata software to perform the heterogeneity test, association test, Begg's and Egger's tests, and sensitivity analysis. We searched three on-line databases (PubMed, Embase, and WOS) and obtained a total of 422 articles. Based on our selection criteria, 24 case-control studies were finally enrolled in this overall meta-analysis; a subgroup analysis by the factors ethnicity, control source, and RVO type was done. Through the association test of overall meta-analysis, we did not observe a significant difference between RVO cases and controls under the A vs G (allele) (z=1.49, P=0.137), A vs G (carrier) (z=1.42, P =0.155), GA vs GG (z=1.50, P=0.135), and GA+AA vs GG (z=1.50, P=0.135). Furthermore, we observed similar negative results in the association test of subgroup analysis (all P>0.05). Heterogeneity, Begg's, and Egger's tests excluded the presence of high heterogeneity and publication bias. Statistically stable results were observed in the sensitivity analyses. Based on integrated analysis of the current evidence, Prothrombin gene G20210A polymorphism is likely unrelated to the risk of RVO.

Automated macular segmentation with spectral domain optical coherence tomography in the fellow eyes of patients with unilateral retinal vein occlusion.

To assess the change in the macular layers in the fellow eyes of unilateral retinal vein occlusion (RVO) patients and to evaluate whether certain layers are more affected based on RVO type. This retrospective study included 87 fellow eyes of patients with unilateral RVO (26 central, 61 branch) and 105 eyes of 105 subjects without RVO. Spectral domain optical coherence tomography was used for automatized retinal segmentation. The thicknesses of retinal nerve fiber layer (RNFL), ganglion cells, inner plexiform, inner nuclear, outer plexiform, outer nuclear, photoreceptor layers, overall inner retinal layers and retinal pigment epithelium (RPE) were documented. Inner plexiform layer was thinner in inferior sector in RVO group compared with the control group (p = 0.047). The subgroup analysis showed that the retina was thinner in RVO group compared with the controls without systemic diseases in some sectors of the following layers: inferior retina, RNFL, ganglion cell layer, inner plexiform layer, inner retinal layers and RPE (p < 0.05). Retinal thickness was decreased in the fellow eyes of branch RVO group compared to that in the central RVO group in the some sectors (p < 0.05). The fellow eyes of unilateral RVO patients did not show major structural differences compared with the controls; however, they revealed significant sectoral thinning in many retinal layers when compared with the eyes of healthy subjects without systemic diseases. Central macula was thinner in the fellow eyes of patients with branch RVO compared to that in central RVO.

Primary angle closure and primary angle closure glaucoma in retinal vein occlusion.

To investigate the frequency of primary angle closure (PAC) and primary angle closure glaucoma (PACG) in patients with retinal vein occlusion (RVO) based on a hospital population. A total of 375 consecutive cases newly diagnosed with RVO by fluorescein fundus angiography at a single eye centre in Peking were reviewed. Gonioscopy was performed in all patients. Glaucoma was diagnosed according to the criteria of the International Society of Geographical and Epidemiological Ophthalmology. Retinal vein occlusion was classified as central retinal vein occlusion (CRVO), hemicentral retinal vein occlusion (HRVO), or branch retinal vein occlusion (BRVO), and as arteriovenous crossing RVO (AV-RVO), optic cup RVO (OC-RVO), optic nerve RVO without optical nerve head swelling (NONHS-RVO), or RVO with optical nerve head swelling (ONHS-RVO) based on the site of venous occlusion. Percentage of PAC or PACG for each type of RVO were calculated. PACG had a frequency of 4.1% [95% confidence interval (CI) 2.2-6.9%] in 317 RVO patients [5.3% (95% CI 2.0-11.2%) in CRVO, 8.8% (95% CI 1.9-23.7%) in HRVO, and 1.9% (95% CI 0.4-5.4%) in BRVO]. Primary angle closure (PAC) had a frequency of 2.9% (95% CI 1.4-5.5%) in RVO. PAC/PACG had a frequency of 11.5% (95% CI 6.3-18.9%) in CRVO, 8.8% (95% CI 1.9-23.7%) in HRVO and 3.1% (95% CI 1.0-7.1%) in BRVO. PAC/PACG was significantly more prevalent in NONHS-RVO [18.9% (95% CI 9.4-32.0%)] than in ONHS-RVO [6.5% (95% CI 2.1-14.5%)], AV-RVO [3.1% (95% CI 0.9-7.8%)], and OC-RVO [2.3% (95% CI 0.1-12.3%)]. The overall frequency of PAC/PACG was much higher in patients with RVO (especially CRVO) than that in the general population. Eyes with PAC/PACG may undergo mechanical changes in the lamina cribrosa of the optic disc, resulting in RVO. Angle-closure conditions should be borne in mind when investigating Chinese patients with RVO.