视网膜静脉阻塞家兔模型的建立

视网膜静脉阻塞(RVO)是眼科常见视网膜血管病变,发病机制尚未完全明了,目前尚无有效的治疗方法。RVO动物模型的建立是其病理和治疗转归研究的基础,本研究的目的是建立一个RVO家兔模型,为今后研究RVO发病机制和治疗实验奠定基础。1材料和方法选用健康成年有色家兔(由浙江省医学科学院实验动物中心提供),雌雄不限,体重2.5～3.0kg。随机分成正常对照组(2只眼)和RVO模型组(12只眼)。RVO模型组再根据RVO后不同时间(1、2、4周)随机分成3组,每组4只眼,每只眼取鼻、颞侧2个电凝点。造模前充分散瞳,采用氯氨酮间断推注及异丙酚静脉维持全身…     

视网膜静脉阻塞继发黄斑水肿发病机制及黄斑水肿影响视功能的研究进展

视网膜静脉阻塞(RVO)是一种常见的视网膜血管疾病,其继发的黄斑水肿(ME)是引起患者视力下降的主要原因。RVO继发ME的发病机制复杂,目前尚未充分阐明,有许多细胞和细胞因子参与其中,使进入和转出视网膜液体之间的平衡被打乱,进而形成ME。本文就RVO继发ME的发病机制以及ME影响视功能的机制展开综述。     

视网膜静脉阻塞引起黄斑水肿的药物治疗进展

视网膜静脉阻塞(retinal vein occlusion,RVO)是临床上常见的眼底血管病,其高发性和对视力的危害性仅次于糖尿病性视网膜病变。RVO的特点是视网膜静脉扩张迂曲,沿静脉分布区域的视网膜出血、水肿和渗出,累及黄斑区时引起黄斑水肿(macular oedema,MO),久之将导致严重的中心视力损害。RVO疾病已被命名有100多年,但是一直以来RVO引起的MO的治疗比较困难。随着治疗方法的不断推新,特别是长效皮质类固醇及近年来的抗血管内皮生长因子类药物的应用,使该病的治疗效果有了较大的改观。我们从RVO引起MO的机制、糖皮质激素和抗血管内皮生长因子药物的作用机制及治疗进展等方面进行阐述,并提出了RVO的未来治疗展望。     

激光诱导脉络膜视网膜静脉吻合治疗视网膜静脉阻塞

视网膜静脉阻塞(retinal vein　occlusion,RVO)目前尚无特殊有效的治疗手段。以激光诱发脉络膜视网膜静脉吻合,为RVO的治疗开辟了新的思路。现介绍激光诱发脉络膜视网膜静脉吻合治疗RVO的机制、适应证、手术方法、并发症、临床应用等方面的进展,以拓宽RVO治疗的思路。(中华眼底病杂志,1999,15:128-129)     

内皮素系统与视网膜静脉阻塞的相关性研究现状

视网膜静脉阻塞(RVO)以视网膜静脉血流受阻、纡曲扩张和视网膜出血、水肿以及新生血管形成为主要特征,其发病机制尚不完全明确。近期研究发现,内皮素(ET)系统中ET-1、ETA受体、ETA信号通路可能通过刺激血管收缩导致视网膜静脉压增高以及诱导TNF-α、IL-6、IL-1β等促炎因子表达等方式参与RVO的发生发展。深入了解ET系统与RVO发生发展的相关性,可为进一步研究RVO发病机制提供新的思路。     

视网膜静脉阻塞动物模型制作的研究进展

视网膜静脉阻塞(RVO)常因黄斑水肿和新生血管性青光眼等严重并发症导致视力下降甚至失明,是仅次于糖尿病视网膜病变的第二位致盲性视网膜血管疾病,是临床诊断和治疗的难点之一.研究表明,本病系多因素、多环节致病,尽管随着医学基础研究和实验技术的发展,对RVO的研究不断深入,但目前其发病机制尚未完全明确,治疗效果尚不肯定.多年来,国内外学者在RVO的病因学、病理学和治疗学等方面建立了多种动物模型.就各种不同模型的制作方法进行归纳和比较,探讨其病理改变的特点,为研究者根据不同研究目的选择合适的动物模型及探讨新的治疗手段提供参考依据.     

正确认识视网膜静脉阻塞的几个问题

视网膜中央静脉阻塞 (central retinal vein occlu-sion,CRVO)及视网膜分支静脉阻塞 (branch retinalvein occlusion,BRVO)是临床上最常见的眼底疾病之一 ,也是合并症较严重、容易导至视力丧失的眼病之一。近年来有关本病的发病机制 ,发展过程 ,予后评估以及治疗措施等都有一些新的认识和进步。但是这些新的观念和措施是否完全正确 ,尚有待更多的临床实践予以检验。现就视网膜静脉阻塞 (retinal vein occlu-sion,RVO)的以下几个方面略作评述。1　 RVO与动脉的关系RVO与动脉的关系 ,不仅仅指所谓的 RVO多见于高血压、动脉硬化的人群…     

视网膜静脉阻塞并发黄斑水肿的联合药物治疗进展

视网膜静脉阻塞(retinal vein occlusion,RVO)是除糖尿病视网膜病变外最常见的视网膜血管疾病,黄斑水肿(macular edema,ME)是RVO的常见并发症,是导致视力下降的主要原因。黄斑水肿的产生被认为与静脉阻塞以后缺血缺氧诱导的血管内皮生长因子(vascular endothelial growth factor,VEGF)以及炎症因素导致的血-视网膜屏障破坏相关,因此目前临床上主要采用玻璃体腔内注射抗VEGF药物或皮质类固醇药物的治疗方式。由于这两种药物作用机制、药效持续时间、不良反应以及价格等方面各有不同,已有多个联合两类药物治疗RVO并发ME的研究报道。本文就联合用药的疗效、注药次数及使用过程中的相关注意事项等方面作一简短综述。     

视网膜静脉阻塞的研究进展

视网膜静脉阻塞(RVO)是一种常见的视网膜血管病变性疾病，其致盲率仅次于糖尿病视网膜病变，由此造成的黄斑水肿、新生血管性青光眼等严重损害了患者的视功能，甚至造成永久的、不可逆的视力下降。近年来，随着大量学者对RVO的进一步研究探讨，对其发生发展又有了更加深入的认识。本文对RVO的发病机制、视力预后的影响因素和治疗的研究进展进行综述。     

中性粒细胞胞外诱捕网相关标志物与视网膜静脉阻塞的相关性研究

目的 探索外周血中性粒细胞胞外诱捕网(NETs)相关生物标志物与视网膜静脉阻塞(RVO)之间的相关性。方法 采用病例对照研究,纳入常熟市第二人民医院眼科2020年1月至7月因RVO入院的患者作为RVO组,从临床中心的体检部门随机选取年龄和性别相匹配的志愿者作为对照组。检测所有受试者外周游离DNA(cfDNA)、髓过氧化物酶(MPO)-DNA和瓜氨酸化组蛋白H3 (H3Cit)三种NETs相关标志物的水平,以及炎症因子[血管内皮生长因子(VEGF)、白细胞介素(IL)-1β和IL-6]和凝血功能指标[血浆样本凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(FIB)]的水平,从而分析NETs与RVO的关系及潜在机制。利用相关性分析探索外周血NETs相关标志物与RVO分型、病程及远期黄斑水肿(ME)发生、炎症水平以及血栓形成的相关性,并进一步分析具有不同水平NETs相关生物标志物的RVO患者中的炎症反应程度和血栓形成标志物的差异。结果 最终纳入了RVO组77例(77眼)患者及对照组受试者48例(48眼)。在RVO组患者外周血中,cfDNA、MPO-DN...     

The burden of disease of retinal vein occlusion: review of the literature

Retinal vein occlusion (RVO) is the second most common cause of vision loss due to retinal vascular disease. A literature review was undertaken to understand the epidemiology, clinical consequence, current practice patterns, and cost of RVO. Pertinent articles were identified by computerized searches of the English language literature in MEDLINE supplemented with electronic and manual searches of society/association proceedings and bibliographies of electronically identified sources. Population-based studies report a prevalence rate of 0.5-2.0% for branch RVO and 0.1-0.2% for central RVO. The 15-year incidence rate is estimated to be 1.8% for branch RVO and 0.2% for central RVO. Patients with RVO report lower vision-related quality of life than those without ocular disease. Available treatment options are limited. Until recently there was no treatment for central RVO. Laser photocoagulation is only recommended for branch RVO in patients who have not experienced severe vision loss. Emerging evidence on the effectiveness of intravitreal anti-vascular endothelial growth factor therapy and dexamethasone intravitreal implant is promising. Information on the treatment patterns and cost of RVO is extremely limited with one retrospective analysis of secondary insurance payment data identified and limited to the United States population only. A better understanding of the economic and societal impact of RVO will help decision makers evaluate emerging medical interventions for this sight-threatening disease.     

Use of cox-2 inhibitors in patients with retinal venous occlusive disease

PURPOSE: To determine the prevalence of prior or current usage of COX-2 inhibitors among patients with retinal venous occlusion (RVO). METHODS: Records of all patients with RVO and control patients matched by age and gender without the diagnosis of RVO seen in a retina referral practice between May 1999 and October 2004 were reviewed. Prevalence of COX-2 inhibitor usage was compared. Multivariable analysis was used to assess the independent correlation of COX-2 inhibitor usage with RVO. RESULTS: A total of 111 consecutive patients with RVO and 316 controls without RVO were identified. There was no significant difference in race or presence of hypertension between cases and controls. Ten of the RVO patients (9%) had a history of using COX-2 inhibitors. Of these 10 patients, one had a central RVO, one had a hemi-central RVO, and eight had a branch RVO. Thirty-nine of the 321 controls (12%) had a history of COX-2 inhibitor use. The prevalence of COX-2 inhibitor usage among RVO patients was not significantly different from that of controls (9% versus 12%; P = 0.37). In a multivariable analysis adjusting for effects of age, gender, hypertension, diabetes, and cardiovascular disease, the association of COX-2 inhibitor usage and RVO was still not significant (P = 0.48). CONCLUSION: A few patients with RVO had prior or concurrent use of COX-2 inhibitors. The prevalence of COX-2 inhibitor usage does not appear to be significantly higher in patients with RVO.     

2019年《EURETINA视网膜静脉阻塞诊疗指南》解读

视网膜静脉阻塞(retinal vein occlusion,RVO)是继糖尿病视网膜病变后常见的眼底血管性疾病。2011年发表的《视网膜静脉阻塞管理专家共识》对RVO的诊疗进行了全面的阐述。2019年8月,欧洲视网膜专家协会(European Society of Retina Specialists,EURETINA)则在2011年专家共识基础上更新了RVO诊疗指南,总结了大型临床试验结果,采纳更强证据等级的数据资料对RVO的诊疗进行了规范。2019年指南形式上采用了"基本原理-证据-推荐"的结构,对RVO进行全面总结。本文对该指南内容进行解读。     

视网膜静脉阻塞性黄斑水肿复发因素的研究进展

视网膜静脉阻塞（RVO）是一种常见的视网膜血管疾病,其继发的黄斑水肿是RVO最常见的并发症,也是引起RVO患者视力下降的主要原因。RVO继发性黄斑水肿的发病因素复杂,并且容易复发,针对其复发因素的分析,目前尚未充分阐明,患者黄斑区结构和血流的变化以及眼内细胞因子的变化等都可能参与其中。本文就RVO继发性黄斑水肿的复发因素进行综述。     

Medical treatment of retinal vein occlusions

The medical treatment of retinal vein occlusion (RVO) is comprised of three main stages: identification and therapy of the detectable risk factors, specific treatment aimed at the occlusive form and treatment of RVO complications. Even though the possible medical management of RVO includes several treatments, the most interesting approaches have been: anticoagulant/antiaggregating agents, troxerutin, corticosteroid, fibrinolytic/thrombolytic agents, and hemodilution. Overall, the medical approach to RVO is still awkward and unsatisfactory. Randomized clinical trials are needed to assess the degree of efficacy of the medical treatment of the specific forms of RVO.     

Medical treatment of retinal vein occlusions

The medical treatment of retinal vein occlusion (RVO) is comprised of three main stages: identification and therapy of the detectable risk factors, specific treatment aimed at the occlusive form and treatment of RVO complications. Even though the possible medical management of RVO includes several treatments, the most interesting approaches have been: anticoagulant/antiaggregating agents, troxerutin, corticosteroid, fibrinolytic/thrombolytic agents, and hemodilution. Overall. the medical approach to RVO is still awkward and unsatisfactory. Randomized clinical trials are needed to assess the degree of efficacy of the medical treatment of the specific forms of RVO.     

眼压在视网膜静脉阻塞中的意义

目的:探讨眼压在视网膜静脉阻塞中的意义。方法:应用TX-F眼压计对23例23眼,视网膜静脉阻塞(retinal vein occlusion,RVO)患者的眼压进行测量。对照组与病例组年龄和性别相配,例数相等。结果:18例RVO阻塞眼眼压较对侧眼有不同程度降低。RVO阻塞眼眼压显著低于对侧眼及正常对照眼(P<0.01)。结论:RVO可引起患者眼压降低。     

Alterations in protein tyrosine kinase pathways following retinal vein occlusion in the rat.

PURPOSE: To determine whether an experimental retinal vein occlusion in the rat activates protein tyrosine kinase pathways and increases angiogenic growth factors in the retina. METHODS: Retinal vein occlusion (RVO) was induced in the rat retina with argon laser photocoagulation. Retinas were collected at 2 days, 1, 2, and 4 weeks after RVO and divided into halves: one half represented an area within the distribution of the occluded vein [RVO(IN)] and the other half represented an area outside the distribution of the occluded vein [RVO(OUT)]. RVO(IN) and (OUT) were examined by western blot analysis of tyrosine-phosphorylated proteins, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and 3 signal proteins in the tyrosine kinase pathways: phospholipase Cgamma (PLCgamma), phosphatidylinositol 3-kinase (PI3K), and mitogen-activated protein kinase (MAPK). RESULTS: RVO caused a severe capillary nonperfusion in RVO(IN). Overall tyrosine-phosphorylated proteins were increased after RVO, especially in RVO(IN) at 2 days and 1 week. VEGF and bFGF were markedly increased in RVO(IN) at 2 days and 1 week. Tyrosine-phosphorylated PLCgamma, PI3K, and MAPK were also increased in RVO(IN) at these time points. CONCLUSIONS: RVO caused an increase in overall protein tyrosine phosphorylation in the rat retina. This increase was associated with an increase in angiogenic growth factors (VEGF and bFGF). These results suggest that protein tyrosine kinase pathways are activated during retinal ischemia and may play a role in mitogenesis of vascular endothelial cells and other responses in the retina after RVO.     

Antithrombotic effect of ticlopidine in an experimental model of retinal vein occlusion

PURPOSE: Ticlopidine inhibits adenosine diphosphate (ADP)-induced platelet aggregation and may be effective in patients with retinal vein occlusions (RVO). This study tests the efficacy of ticlopidine in an animal model of RVO. METHODS: Rose bengal-mediated argon laser photothrombosis of retinal veins was created in rabbits pretreated with oral ticlopidine, aspirin, or saline. The number of laser spots necessary to produce a partial or complete RVO was recorded and tabulated. RESULTS: Pretreatment with ticlopidine significantly increased the number of laser spots needed to produce a partial (P =.02), or a complete (P =.002) RVO as compared to the control group. Pretreatment with ticlopidine significantly increased the number of laser spots needed to produce a partial RVO (P =.02). Pretreatment with aspirin significantly increased the number of laser spots needed to produce a complete RVO (P =.002). CONCLUSION: Ticlopidine may be a useful antiplatelet agent for the treatment of patients with RVO. Patients treated with ticlopidine should be monitored for the possible development of hematologic disorders.