Ischemic retinal vein occlusion: characterizing the more severe spectrum of retinal vein occlusion

Retinal vein occlusion (RVO)-including central RVO, branch RVO, and hemicentral and hemispheric RVO—is the second most common vascular cause of visual loss, surpassed only by diabetic retinopathy. The presence and extent of retinal ischemia in RVO is associated with a worse prognosis. On this basis, most previously conducted studies considered ischemic retinal vein occlusion (iRVO) and non-iRVO as separate entities based on set thresholds of existing retinal ischemia as determined by fundus fluorescein angiography. Other diagnostic technologies have been used specifically in the differentiation of ischemic central retinal vein occlusion and nonischemic central retinal vein occlusion. To date, there is no fully accepted definition for iRVO. Some clinicians and researchers may favor establishing a clear differentiation between these forms of RVO; others may prefer not to consider iRVO as a separate entity. Whatever the case, retinal ischemia in RVO confers a higher risk of visual loss and neovascular complications; thus, it should be determined as accurately as possible in patients with this disease and be considered in clinical and experimental studies. Most recently conducted clinical trials evaluating new treatments for macular edema secondary to RVO included none or only few patients with iRVO based on previous definitions (i.e., few patients with sizeable areas of retinal ischemia were recruited in these trials), and thus it is unclear whether the results observed in recruited patients could be extrapolated to those with retinal ischemia. There has been scant research aiming at developing and/or testing treatments for retinal ischemia, as well as to prevent new vessel formation as a result of RVO. We provide a detailed review of the knowledge gathered over the years on iRVO, from controversies on its definition and diagnosis to the understanding of its epidemiology, risk factors and pathogenesis, the structural and functional effects of this disease in the eye and its complications, natural history, and outcomes after treatment. In each section, the definition of iRVO used is given so, independently of whether iRVO is considered a separate clinical entity or a more severe end of the spectrum of RVO, the information will be useful to clinicians to determine patient's risk, guide therapeutic decisions, and counsel patients and for researchers to design future studies.     

Retino-choroidal ischemia in central retinal vein occlusion

A 41-year-old gentleman with insulin dependent diabetes had decreased vision in the right eye due to non-ischemic central retinal vein occlusion with macular edema. One month following intravitreal ranibizumab, he developed retino-choroidal ischemia with further loss of vision. Authors show the fluorescein angiographic transition from non-ischemic central retinal vein occlusion to retino-choroidal ischemia.     

Combined central retinal vein and cilioretinal artery occlusion

We present a case of combined central retinal vein and cilioretinal artery occlusion which, due to the absence of the temporal branch retinal artery, was initially misdiagnosed as a combined central retinal vein occlusion and temporal branch retinal artery occlusion. Given that – in contrast to cases of combined central artery and central retinal vein occlusion – the prognosis for cilioretinal artery occlusion with central retinal vein occlusion is quite good, this case illustrates the importance of suspecting an unusual condition in the presence of a combined occlusion.     

放射状视神经切开术治疗视网膜中央静脉阻塞的效果观察

目的观察放射状视神经切开术(RON)治疗视网膜中央静脉阻塞(CRVO))的效果。方法CRVO患者7例(7眼),均进行眼科常规检查、眼底荧光血管造影(FFA)和光学相干断层扫描(OCT)检查后确诊。行标准三通道闭合式玻璃体切除手术后,使用改良的MVR刀在视盘鼻侧缘做放射状视神经切开术。结果术中和术后无严重并发症。6例术后视网膜出血、静脉迂曲扩张和黄斑水肿等视网膜淤滞状态逐渐消退,视力均有不同程度的提高。1例年轻患者术后发生玻璃体积血。结论RON手术可以改善CRVO的视网膜淤滞状态和提高视力,但需要进一步观察手术的远期效果。     

影响视网膜静脉阻塞及黄斑中心视网膜厚度改变的因素分析

目的:分析不同危险因素对视网膜静脉阻塞(RVO)发病的影响,同时观察并研究不同因素对黄斑中心视网膜厚度(CRT)的影响。方法:回顾性研究。收集2016-09/2019-04我院眼科就诊的RVO患者79例79眼作为RVO组,并根据CRT是否大于369μm将其分为高CRT组(26眼)和低CRT组(53眼)。收集同时期入院拟行白内障手术患者59例59眼作为对照组。统计分析RVO发病危险因素以及影响CRT改变的因素。结果:与对照组相比,RVO组中高血压、颈动脉斑块以及高同型半胱氨酸血症有差异(P<0.05)。不同CRT分组间分析结果则显示中央部位阻塞和吸烟史有差异(P<0.05)。结论:高血压、颈动脉斑块、高同型半胱氨酸血症是RVO发病的危险因素。而中央部位阻塞以及吸烟史是影响CRT厚度改变的因素。     

同型半胱氨酸与视网膜静脉阻塞

视网膜静脉阻塞是一种常见的视网膜血管性疾病,为多因素致病,目前对其病因还不能系统而准确的了解。近年来,对高同型半胱氨酸血症与视网膜静脉阻塞关系的研究有了较大进展,但结果仍存在争议。     

视网膜分支静脉阻塞的临床分析

目的 为了了解视网膜分支静脉阻塞患者的合并症发生的情况。 方法 回顾性地分析本院1995年10月到1999年10月277例（277只眼）视网膜分支静脉阻塞的病例。 结果 70%以上的病例发病年龄均在55岁以上，81.58%的分支静脉阻塞发生于颞上及颞下象限。分支静脉阻塞合并症的发生率与阻塞的位置密切相关，愈大的分支静脉阻塞，其无灌注区及新生血管的发生率也就愈高。 结论 视网膜分支静脉阻塞黄斑水肿发生在发病的早期，无灌注区的出现多在7～12个月，而新生血管的出现，多半在一年以后，因此对这些患者应当有更长期的追踪观察。 （中华眼底病杂志，2002，18：17-19）     

视网膜中央静脉阻塞治疗研究进展

视网膜中央静脉阻塞是临床上常见的视网膜疾病,因严重的并发症导致视力下降甚至失明,到目前为止尚无针对其病因的确切有效的治疗方法。近年来激光光凝、激光诱导视网膜脉络膜吻合、视网膜静脉t-PA注射、玻璃体腔内注射、放射状切开等手术方法为视网膜中央静脉阻塞带来了新的观念,我们将对上述几种方法的实验和临床研究作简要综述。     

视网膜静脉阻塞的危险因素分析

目的 分析视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)和视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)的危险因素;并对CRVO和BRVO危险因素进行直接比较.方法 对46例CRVO(CRVO组)、33例BRVO(BRVO组)与79例老年性白内障或屈光不正患者(对照组)行危险因素和血脂谱分析,并对比观察.结果 多元线性回归分析结果显示:高同型半胱氨酸血症(P＜0.000 1)、高总胆固醇(P=0.003 0)、高脂蛋白a(P =0.027 0)、高血压(P =0.022 0)、短眼轴(P ＜0.000 1)与CRVO显著相关;而高同型半胱氨酸血症(P＜0.0001)、高总胆固醇(P =0.008 0)、高血压(P=0.002 0)、高体质量指数(P=0.004 0)、短眼轴(P=0.001 0)与BRVO相关.一元线性回归分析示CRVO和BRVO上述危险因素比较没有明显差别.结论 CRVO、BRVO危险因素包括系统(高血脂、高血压、高同型半胱氨酸)和眼部(短眼轴)的多种因素,但是这些危险因素在CRVO和BRVO之间没有显著差异.     

视网膜静脉阻塞的治疗进展

我们从药物治疗、激光治疗和手术治疗等3个方面阐述了视网膜静脉阻塞的治疗近况,并提出了视网膜静脉阻塞未来治疗的展望。     

Combined central retinal artery and vein occlusion in a child with systemic non-Hodgkin's lymphoma

Purpose: To report on a case of systemic non-Hodgkin's lymphoma and unilateral combined central retinal artery and vein occlusion. Method: We examined a 14-year-old boy who experienced a sudden unilateral visual loss five months after the initial diagnosis of systemic non-Hodgkin's lymphoma. Result: Visual loss was due to combined central retinal artery and vein occlusion in association with tumoral optic nerve involvement. Conclusion: Alhough very rare systemic non-Hodgkin's lymphoma may present with central retinal artery and vein occlusion prior to overt central nervous system involvement. This revised version was published online in July 2006 with corrections to the Cover Date.     

视网膜静脉阻塞的治疗进展

视网膜静脉阻塞是临床上常见的视网膜疾病,常因严重的并发症致视力下降甚至盲目,到目前尚无针对病因的确切有效的治疗方法。随着对该病发病机制的认识以及眼科技术的发展,国内外学致力研究的方法在动物实验和临床试验都取得了一定成效。     

视网膜静脉阻塞的治疗趋势

视网膜静脉阻塞是仅次于糖尿病视网膜病变的常见视网膜血管病,在疾病的认识史上,它“古老”而“陌生”。致病的多因素及其慢性积累、突然发作,是此病重要特点。目前,在其病因、自然病程和治疗方面仍存在很多争议。眼科治疗的目的主要是控制黄斑水肿、新生血管形成等并发症。抗VEGF疗法的持续应用与玻璃体内注射曲安奈德以及视网膜光凝等联合疗法,形成了目前的治疗趋势。     

视网膜静脉阻塞的预后分析

对近年来关于视网膜静脉阻塞预后的研究进展进行综述，包括影响视网膜静脉阻塞预后的相关因素，各种治疗措施对其预后的影响及判断预后的辅助检查方法。认为临床中应积极防治并发症，争取患者最佳预后视力。     

眼球轴长与视网膜中央静脉阻塞关系的探讨

目的探讨眼球轴长与视网膜中央静脉阻塞(centralreinalveinocclusion,CRVO)的相关关系.方法采用A超测量30例CRVO患者及120例年龄匹配的正常人及白内障摘除患者眼球轴长.结果CRVO组患眼平均轴长(22.54±0.74)mm,对侧眼平均轴长(22.95±0.92)mm;经统计学处理,差异无显著性(t=2.94,P>0.05).对照组右眼平均轴长(23.45±0.66)mm,左眼平均轴长(23.56±0.95)mm,左右眼比较差异无显著性(t=1.96,P>0.05).CRVO组患眼与对照组轴长比较,差异有显著性(t=4.09,P<     

Hyperhomocysteinemia and central retinal vein occlusion in Iranian population

Purpose To evaluate total plasma homocysteine level during the acute phase of central retinal vein occlusion (CRVO) in the Iranian population and determine whether hyperhomocysteinemia is also a risk factor for CRVO. Methods Fifty-four patients with recently diagnosed CRVO were studied. Their fasting total plasma homocysteine level was compared with a matched control group of 51 patients evaluated in the same clinic for a non-retinal disease diagnosis. Results The mean total plasma homocysteine level was 14.76 ± 7.67 μmol/l in cases, and 11.42 ± 3.74 μmol/l in control subjects. It showed a significant difference (P = 0.005) in mean plasma homocysteine level between cases and control group. Odds ratio of CRVO for individuals with hyperhomocysteinemia was 2.88 (95% CI = 1.08−7.71 and P = 0.03). The overall multivariable-adjusted odds of CRVO in participants with plasma homocysteine level above 15 μmol/l was 4.71 (95% CI = 1.46−15.19 and P = 0.009) Hyperhomocysteinemia was not statistically different in each age group (< 60 years: 27%, 61−70 years: 33.3%, 71−80 years: 31.6%, > 81 years: 33.3%, Chi-square test, P = 0.98). Conclusion Elevated total plasma homocysteine level is an independent risk factor for CRVO in Iranian population. In addition to an evaluation of all conventional cardiovascular risk factors, measurement of total homocysteine for evidence of hyperhomocysteinemia may be important in the initial investigation and management of patients with CRVO.     

视网膜中央静脉阻塞合并原发性青光眼临床分析

本文１５６例视网膜中央静脉阻塞中，有１７例同时或先后发生了原发性青光眼（１０９０％）。其中开角型青光眼１４例，闭角型青光眼３例，全部青光眼病人眼压高于４７６ｋＰａ以上。Ｃ／Ｄ值≥０７。闭角型青光眼房角均为窄Ⅲ—窄Ⅳ。且有部分房角粘连性闭合。视网膜中央静脉阻塞眼有３４％视力≥０２，而视网膜中央静脉阻塞合并原发性青光眼只有２４％视力≥０２，在视力指数—无光感病人中，视网膜静脉阻塞眼占２２％，视网膜中央静脉阻塞合并原发性青光眼则占５８％。本文结果显示原发性青光眼对视网膜中央静脉阻塞病人视力有严重影响。我们对视网膜中央静脉阻塞与原发性青光眼的关系进行了讨论。     

视网膜中央静脉阻塞黄斑水肿的治疗新进展

视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)是一种常见的视网膜血管性疾病,黄斑水肿是其主要并发症也是导致视力下降的主要原因。目前临床广泛应用及研究的热点主要有激光光凝,玻璃体注药治疗:曲安奈德、血管内皮生长因子抗体,手术治疗:放射状视神经切开术等。