Radiation Retinopathy Associated with Central Retinal Vein Occlusion

Purpose: To report a case of radiation retinopathy associated with central retinal vein occlusion. Methods: The clinical features and fundus fluorescein angiography of this case were analyzed. Results: The patient had been treated with radiotherapy for her nasopharyngeal carcinoma, and presented with sudden visual loss in the left eye. The funduscopic examination and fluorescein angiography showed the features of radiation retinopathy in both eyes, and central retinal vein occlusion in the left eye. Conclusions: Radiation retinopathy can be associated with central retinal vein occlusion in the same eye, and it seems that the endothelial cell loss caused by radiation retinopathy may lead to retinal vein occlusion.     

47岁男性患者视网膜中央静脉阻塞后的脉络膜新生血管膜

1例46岁白人男性患者被转诊于马里兰州巴尔地摩市Wilmer眼科研究所，对其患有的黄斑水肿进行诊治。5个月前，转诊眼科医生通过眼底照像和眼底荧光血管造影检查，诊断他的右眼患有无灌注性的视网膜中央静脉阻塞（CVO）（图1）。患者有高胆固醇血症的病史，服用的药物包括阿司匹林和降脂药物。     

视网膜静脉阻塞并发症新生血管的研究现状

新生血管是视网膜静脉阻塞最严重的并发症,也是最常见的致盲眼病。我们通过对国内外近年来有关新生血管研究 进展文献的复习,对新生血管产生的因素、机理、生长过程以及新生血管的西医和中医治疗现状进行了综述,旨在进一步了 解新生血管产生的机理,并探索防治视网膜静脉阻塞并发症新生血管的新方法。     

Triamcinolone Intravitreal Injection and Intraocular Pressure in Macular Edema Associated with Retinal Vein Occlusion

 Purpose: To study the risk factors of increased intraocular pressure (IOP) response to triamcinolone acetonide intravitreal (IVTA) injection in eyes with macular edema associated with retinal vein occlusion. Methods: Eighty-nine eyes with macular edema associated with retinal vein occlusion first received periocular injection of 40 mg triamcinolone acetonide (TA) and were followed for one month. According to the diversity of IOP after periocular TA (PTA) injection, they were divided into the elevation IOP group (group A, 26 eyes) and the normal IOP group (group B, 63 eyes). They then received 4 mg TA intravitreal injection. IOP measurements were recorded after PTA and IVTA injections, and were followed for six months. Results: Both PTA and IVTA injections caused a rise in IOP, but it was higher in the IVTA injection (40.45%) than in the PTA injection (29.21%). The mean rise in IOP was more significant in eyes with IVTA injection (28.08 ± 8.24 mmHg) than in eyes with PTA injection (20.87 ± 4.07 mmHg). Patients with an elevation IOP above 6 mmHg after PTA injection had a 73.08% chance of developing a pressure of 24 mmHg or higher, whereas only 12.70% of those with an elevation IOP below 6 mmHg after PTA injection experienced pressure elevation. Conclusion: IOP response to PTA injection is a good way to judge IOP response to IVTA. If the patient is highly sensitive to corticosteroid, treatments other than IVTA injection are used to avoid the increased risks associated with intravitreal corticosteroid injection.     

视网膜静脉阻塞家兔血管内皮生长因子的表戴

目的研究血管内皮生长因子(Vascular Endothelial Growth Factor,VEGF)在视网膜静脉阻塞(RetinalVein Occlusion,RVO)中的作用及在视网膜新生血管中的参与机制.方法经玻璃体眼内电凝法建立RVO家兔模型,利用荧光素眼底血管造影(Funds Fluorescein Angiography,FFA)观察视网膜及血管的情况,采用免疫组化观察对照组、模型组视网膜组织中VEGF蛋白的表达情况.结果正常家兔视网膜组织中VEGF免疫反应弱.模型组与正常对照组比较,阻塞近端术后2wk、4wk,P＜0.05(P=0.000,0.024),差异有显著性,而术后1wk,P＞0.05(P=0.144),差异不明显.各组两两比较,2 wk组与1 wk、4wk组,P＜0.001(P=0.000,0.000),差异有显著意义.结论VEGF蛋白表达在视网膜局部缺血时提高,在再通或侧支循环形成时降低,与RVO眼内组织缺血形成存在一定的时空对应关系.     

Intravitreal Ranibizumab in the Treatment of Butterfly-Shaped Pattern Dystrophy Associated with Choroidal Neovascularization: A Case Report

Purpose

To present and document the effectiveness of intravitreal ranibizumab in the treatment of patients with choroidal neovascularization due to butterfly-shaped pattern dystrophy (PD) of the macula.

Methods

Three intravitreal ranibizumab injections of 0.5 mg/0.05 ml in monthly intervals were given to a patient with a previously diagnosed butterfly-shaped PD who subsequently developed subfoveal choroidal neovascularization on the right eye. The patient had previously received a combination of verteporfin/photodynamic therapy for a juxtafoveal choroidal neovascular membrane on the left eye.

Results

At the end of the treatment course, there was significant improvement of the patient''s vision and the appearance of the macula on optic coherence tomography and fluorescein angiography. Best-corrected visual acuity improved from 6/12 to 6/6 and retinal thickness at the macula decreased from 323 to 247 μm. No subretinal fluid remained. The patient is clinically stable over a 12-month follow-up period.

Conclusions

Intravitreal ranibizumab seems to be an effective and safe option for the treatment of subfoveal choroidal neovascularization in patients with butterfly-shaped PD.Key Words: Intravitreal ranibizumab, Pattern dystrophy of the macula, Choroidal neovascular membrane, Choroidal neovascularization     

A Moyamoya Patient with Bilateral Consecutive Branch Retinal Vein Occlusion

We describe a moyamoya (MMD) patient with bilateral consecutive branch retinal vein occlusion (BRVO). The patient had a medical history of severe headache, cranial haemorrhage, bilateral supraclinoid carotid artery occlusion, and “puff of smoke” collaterals on cerebral angiography and an encephalomyosynangiosis operation. On ophthalmic examination, he had superior temporal branch vein occlusion with intraretinal haemorrhage and visual acuity of 20/25 in the right eye. Twelve years later, he presented with superior temporal branch vein occlusion in the left eye and visual acuity of 20/60. The patient was initially treated with a dexamethasone intravitreal implant, and later intravitreal ranibizumab injections. We describe the first reported case of bilateral consecutive BRVO and management in MMD.