Prevalence of factor V Leiden in patients with retinal vein occlusion

PURPOSE: Factor V Leiden mutation is a common genetic defect associated with a tendency to venous thrombosis. The aim of this study was to evaluate the prevalence of factor V Leiden in patients with retinal vein occlusion (RVO). METHODS: Blood samples were obtained from fifty RVO patients and were tested for factor V Leiden using DNA analysis. Twenty-three patients had central RVO (CRVO), twenty-five had branch RVO (BRVO) and two had CRVO in one eye and BRVO in the other eye. RESULTS: DNA analysis showed that only 4 patients (8%) were heterozygous carriers of factor V Leiden. None of the patients were found to be homozygous. In the control group 11 (9.2%) were heterozygous carriers of factor V Leiden. The difference between the patients and the controls was not statistically significant. CONCLUSION: There was no clear association between RVO and factor V Leiden in this pool of patients. Factor V Leiden does not seem to play an important role in the development of RVO.     

Multifocal electroretinograms in patients with retinal vein occlusion

PURPOSE: To investigate waveform changes of multifocal electroretinograms(mERG) in patients with retinal vein occlusion(RVO). METHODS: Nine eyes of 8 patients with RVO and 29 eyes of 29 normal subjects were examined using mERG. An array of 103 hexagonal elements was displayed on a monitor. mERG latencies(ms) and response densities (nV/deg2) were measured for center area(Ct) and for each of four quadrant areas. The peak and troughs were named N1, P1 and N2, consecutively. RESULTS: In pathological quadrants, although the response densities were abnormal in only one eye, latencies of the N2 and P1 were prolonged in 7 eyes and in 2 eyes, respectively(over 1 SD-2 SD). The latencies were significantly prolonged compared with those of normal eyes(p < or = 0.03, U-test). On the other hand, in the central area, although the latencies were abnormal in 3 eyes, the response densities were reduced in 6 eyes(over 1 SD-2 SD). The response densities were significantly reduced compared with those of normal eyes(p < or = 0.024, U-test). CONCLUSIONS: Both peak latencies in pathological quadrants and response densities in the central retinal area can be sensitive indicators of retinal dysfunction caused by RVO. The mERG system is useful for detecting local retinal dysfunction in patients with RVO.     

Choroidal thickening in retinal vein occlusion patients with serous retinal detachment

Graefe's Archive for Clinical and Experimental Ophthalmology - To evaluate choroid thickness and macular retinal metrics in treatment naïve retinal vein occlusion (RVO) patients with...     

Cardiovascular risk assessment in patients with retinal vein occlusion

AIM: Patients with retinal vein occlusions (RVO) are at increased risk of cardiovascular disease (CVD). The risk of future CVD was determined using the Framingham algorithm and this risk estimate was used to guide decisions about preventative treatment for CVD in RVO patients. METHODS: 107 unselected RVO patients were studied. After excluding 18 patients because of age, missing data, or pre-existing cardiovascular disease, the calculated coronary heart disease risks (cCHDR) and calculated cardiovascular disease risks (cCVDR) were calculated on the 89 remaining and compared with both the standardised risk and the published incidence of CHD in England by t test or chi(2) test. RESULTS: The mean 10 year cCVDR was significantly higher than the Framingham standardised risk for all RVOs (20.6% (1.2%) v 15.7% (1.1%), p = 0.009) and female RVOs (17.8% (1.2%) v 12.7% (1.0%), p = 0.022) in particular. The 10 year cCHDR, compared to the actual incidence of CHD in England between the ages of 30 and 74 years, was > 15% in twice as many males than expected (62% v 28%, p <0.0001). This rose to almost six times when cCHDRs greater than 30% were compared (17% v 3%, p = 0.002). There was a fourfold increase in the proportion of female RVO patients with a cCHDR above 15% (40% v 9%, p <0.0001) and at a cCHDR of 30% and above (10% v 0%, p = 0.004). There were also significant differences in the cCHDR between central and branch RVO (both sexes). The branch form of RVO (BRVO) having higher cCHDRs because of systolic hypertension (164.1 (21.6) mm Hg v 149.5 (23.5) mm Hg, p = 0.003) and age (61.7 (8.3) years v 56.7 (10.6) years, p = 0.017). CONCLUSIONS: RVO is the presenting complaint in a group of patients at increased risk of CVD and is in agreement with the long term follow up data demonstrating an increased mortality from CVD in patients with RVO. The Framingham algorithm can accurately determine the cCHDR (or cCVDR) to assist the clinician in deciding who to treat in accordance with the Joint British Societies' guidelines, with particular regard to hypertension, lipid lowering, and the use of aspirin therapy.     

视网膜静脉阻塞激光治疗后玻璃体出血的临床分析

目的：了解视网膜静脉阻塞(RVO)激光治疗后发生玻璃体出血的原因。方法：回顾分析2年来门诊11例(11眼，CRVO：2眼；BRVO：9眼)激光后的视网膜静脉阻塞发生玻璃体出血的病例。结果：11例RVO中：少量玻璃体出血5例；中-多量玻璃体出血6例，其中2例作玻璃体切除术，其余激光治疗后出血停止而治愈。由初次激光治疗到玻璃体出血时间6月-11年，再次激光或／和手术后视力均有改善。结论：不规范或不完全的视网膜光凝是导致RVO激光治疗发生玻璃体出血的主要原因，规范的视网膜光凝、定期随诊和眼底荧光造影是保证疗效的关键。     

Central visual field in patients with retinal branch vein occlusion

We studied the central visual fields in 11 eyes with retinal branch vein occlusion that presented extensive areas of capillary nonperfusion by fluorescein angiography. Relative scotomata corresponding to the areas of capillary nonperfusion were seen in seven eyes where the venous occlusion was of recent onset (average, 11 months). In the remaining four eyes with long-standing venous occlusion (average, 24 months), capillary occlusion was associated with absolute scotomata.     

视网膜分支静脉阻塞伴视网膜脱离21例手术疗效分析

目的 分析视网膜分支静脉阻塞伴视网膜脱离的手术治疗效果.方法 回顾性分析视网膜分支静脉阻塞伴视网膜脱离21例（21眼）的手术治疗效果,随访6～18个月,观察视力、眼底及视网膜复位情况.结果 视网膜分支静脉阻塞以颞侧分支尤其是颞上支静脉为主;视网膜裂孔为圆形及马蹄形,均位于牵引点附近,沿血管分布.进行玻璃体切除视网膜脱离复位手术及眼内激光光凝.随访6～18个月,所有患者视网膜均复位,19眼（90.5％）视力改善明显,3眼（9.5％）保持不变.无严重并发症发生.结论 及时进行视网膜脱离复位及激光光凝术是治疗视网膜分支静脉阻塞伴视网膜脱离的有效方法.     

年轻视网膜中央静脉阻塞患者的临床进程

目的描述55岁以下的视网膜中央静脉阻塞(CR-VO)患者的临床进程。设计和方法回顾性非比较性的连续病例分析。复习了67例患者的人口统计学、影像、临床和视力数据。对其中随访6个月以上(平均29.2个月)的病例资料进行了统计学分析。主要结果测定最佳矫正视力和眼内新生血管形成的发病率。结果在连续的67例(男性55%,平均年龄45岁)患者中,视力平均为20/50。其中45例(67%)患者被查出至少有1种全身性疾病。在57例随访6个月以上的患者中,最终视力20/40(含)以上的占42%,20/50-20/100的占18%,20/200(含)以下的占40%.在CRVO发病的3-6个月内,绝大部分患者出现了视力减退。在发病的12个月以后,出现视力提高的极少见。就诊视力在20/40(含)以上的22例患者中,36%的患者在最近的1次检查中视力下降到了20/400甚至更低。就诊视力在20/200-20/400的10例患者中,8例视力提高到20/60甚至更高。就诊视力在数指或者更差的6例患者中,没有1例视力得到改善。在CRVO发病的1-9个月内,10例(18%)患者被诊断为眼内新生血管形成。其中前节新生血管形成的患者有6例(11%),包括3例(5%)新生血管性青光眼。新生血管形成的发生与患者的性别、年龄、有无伴随疾病、症状的持续时间和就诊视力均没有明显关系。结论年轻患者的CRVO有着多变的临床过程     

视网膜静脉阻塞患者高凝状态的检测分析

检测36例早期视网膜静脉阻塞(RVO)患者和20例正常人的血小板聚集与释放功能、血浆凝血因子和纤溶活性。结果,RVO患者的血小板聚集率、血浆纤维连接蛋白、因子Ⅷ相关抗原和纤溶酶原均高于正常人。表明RVO患者的血液呈高凝状态。这种血液凝固性异常可能在RVO的发生发展及其缺血性并发症上起重要作用。     

Evaluation of arterial stiffness in patients with branch retinal vein occlusion

PURPOSE: To assess the arterial stiffness in patients with branch retinal vein occlusion (BRVO). METHODS: Brachial-ankle pulse wave velocity (PWV) and ankle-brachial index were measured in 10 patients with BRVO (mean age 67.9 +/- 7.5 years) and in 18 age-matched controls (mean age 66.9 +/- 6.8 years). The controls were subjects with systemic essential hypertension having no retinal lesions. RESULTS: The PWV in the BRVO group was 1,946 +/- 254 cm/s which was significantly higher than that in the control group (1,688 +/- 274 cm/s; p = 0.014, Wilcoxon rank sum test). The ankle-brachial indexes were 1.16 and 1.15 in BRVO and control groups, respectively. There was no significant difference between the groups (p = 0.944). In the control group, there was a significant positive correlation between PWV and systolic blood pressure (Spearman correlation coefficient r(s) = 0.385, p = 0.043), while no significant correlation was found in the BRVO group (Spearman correlation coefficient r(s) = -0.188, p = 0.603). CONCLUSION: The arterial stiffness is increased in patients with BRVO which was thought to be due to the structural changes of the artery and not dependent on the blood pressure.