Objective To investigate the complications of the Branch Retinal Vein Occlusion. Methods Two hundred and seventy-seven cases (277eyes) of branch retinal vein occlusion (BRVO) have been studied retrospectively from 1995 October to 1999 October Results Most cases of BRVO occured after the age over fifty-five. About 81.85% BRVO affected at supiriotemporally and inferiotemporally. The incidence of the complication of BRVO is closely related to the site of obstrution, the larger branch vein occlusion the higher incidence of the nonperfusion area and neovascularization Conclusion The macular edema occured in the early stage of the BRVO, and most non-perfusion areas were observed between six to twelve months. The neocvscularization always observed after one year later from the vein obstruction. So that the patient have to be followed carefully with a long duration. （Chin J Ocul Fundus Dis,2002,18:17-19）
ObjectiveTo systematically review anti-vascular endothelial growth factor (VEGF) drugs on visual acuity in patients with central vetinal vein occlnsion-macular edema (CRVO-ME). MethodsDatabases including PubMed, The Cochrane Library (Issue 11, 2012), EMbase, CBM, CNKI, VIP and WanFang Data were electronically searched for the randomized controlled trials (RCTs) about anti-VEGF drugs on visual acuity in patients with CRVO-ME from the date of establishment of the databases to December 2012. Two reviewers independently screened literature according to the inclusion and exclusion criteria, and evaluated the included studies. Then, meta-analysis was performed using RevMan 5.1 software. The quality of evidence was analyzed using GRADEpro 3.6 software. ResultsA total 9 trials involving 1 072 patients (1 072 eyes) were included. The results of meta-analysis showed that, anti-VEGF injection, compared with sham injection, increased BCVA score measured by ETDRS (MD=16.27, 95%CI 9.98 to 22.55, P < 0.000 01); decreased CFT score measured by OCT (MD=245.25, 95%CI 136.02 to 354.48, P < 0.000 1); gained more than 15 letters in BCVA (OR=4.43, 95% CI 2.23 to 8.83, P < 0.000 1); and the long term anti-VEGF effect index, gained no less than 15 letters in BCVA (OR=2.25, 95% CI 1.56 to 3.23, P < 0.000 1). The score of short term BCVA changes was of intermediate quality, while another three outcomes were of low quality in the GRADE system. ConclusionCurrent evidence shows that, anti-VEGF drugs could improve the visual acuity of patients with CRVO-ME. The clinicians could recommend this kind of drugs to the patients. Due to the limitations of the included studies, more large-sample multicentre high-quality RCTs are required to verify its effectiveness.
Objective To explore the influencing factors of visual prognosis of macular edema secondary to branch retinal vein occlusion (BRVO-ME) after treatment with ranibizumab, and construct and verify the nomogram model. MethodsA retrospective study. A total of 130 patients with BRVO-ME diagnosed by ophthalmology examination in the Department of Ophthalmology, Liuzhou Red Cross Hospital from January 2019 to December 2021 were selected in this study. All patients received intravitreal injection of ranibizumab. According to the random number table method, the patients were divided into the training set and the test set with a ratio of 3:1, which were 98 patients (98 eyes) and 32 patients (32 eyes), respectively. According to the difference of logarithm of the minimum angle of resolution (logMAR) best corrected visual acuity (BCVA) at 6 months after treatment and logMAR BCVA before treatment, 98 patients (98 eyes) in the training set were divided into good prognosis group (difference ≤－0.3) and poor prognosis group (difference ＞－0.3), which were 58 patients (58 eyes) and 40 patients (40 eyes), respectively. The clinical data of patients in the two groups were analyzed, univariate and multivariate logistic regression analysis were carried out for the different indicators, and the visualization regression analysis results were obtained by using R software. The consistency index (C-index), convolutional neural network (CNN), calibration curve and receiver operating characteristic (ROC) curve were used to verify the accuracy of the nomogram model. ResultsUnivariate analysis showed that age, disease course, outer membrane (ELM) integrity, elliptical zone (EZ) integrity, BCVA, center macular thickness (CMT), outer hyperreflective retinal foci (HRF), inner retina HRF, and the blood flow density of retinal deep capillary plexus (DCP) were risk factors affecting the visual prognosis after treatment with ranibizumab in BRVO-ME patients (P＜0.05). Multivariate logistic regression analysis showed that course of disease, ELM integrity, BCVA and outer HRF were independent risk factors for visual prognosis after ranibizumab treatment for BRVO-ME patients (P＜0.05). The ROC area under the curve of the training set and the test set were 0.846[95% confidence interval (CI) 0.789-0.887) and 0.852 (95%CI 0.794 -0.873)], respectively; C-index were 0.836 (95%CI 0.793-0.865) and 0.845 (95%CI 0.780-0.872), respectively. CNN showed that the error rate gradually stabilized after 300 cycles, with good model accuracy and strong prediction ability. ConclusionsCourse of disease, ELM integrity, BCVA and outer HRF were independent risk factors of visual prognosis after ranibizumab treatment in BRVO-ME patients. The nomogram model based on risk factors has good differentiation and accuracy.
The activities of tissue- type plasminogen activator (t-PA) and plasminogen activator inhibitor(PAl) in plasm from 61 patients with retinal vein occlusion (RVO) were measured by using chromatogenous substrate s-2390 assay.The results showed that the t-PA activity in the patients with RVO were decreased (1.69plusmn;0. 56IU/ml, P＜0.01) and PAI activity increased (8.80plusmn;1.60AU/ml, P＜0. 01) comparing with health subjects 2.07plusmn;0.40IU/ml and 7.33plusmn;0.67AU/ml respectively. Among the patients, t-PA activity in the patients with ischemic retinopathy was more obviously decreased (1.35plusmn;0.43IU/ml, P＜0.01) and the activity of PAI was increased (9.35plusmn;1.37AU/mi) comparing with those patients suffering from nonischemic retinopathy (the activities of t-PA and PAI were 1.92 + 0.53IU/ml and 8.42plusmn;1.29AU/ml respectively, Plt;0.01). In addition, these changes were getting more obvious with the degree of severity of the disease. These results indicated that there was disorder in the balance between t-PA and PAI in patients with RVO,which my play an important role in the course of occurrence and development of RVO, especially in ischemic type. （Chin J Ocul Fundus Dis,1994,10:71-73）
With high morbidity, branch retinal vein occlusion (BRVO) is a common retinal vascular disease in the clinic. Although the classic characteristics of BRVO have been recognized for a long time, the traditional understanding of BRVO has been challenged along with development and application of new imaging technologies, including the reasonable classification and staging of the disease, and the vascular characteristics at the occlusive site via multimodal imaging, etc. Thus, re-summarizing and refining these features as well as further improving and optimizing traditional imaging evaluation, can not only deepen the correct acknowledge of the entity, but also find biomarkers of prognosis of visual function, which is helpful to establish better diagnosis and treatment strategy. In the meanwhile, it is necessary that clinical characteristics of BRVO on imaging and the reliability of these imaging techniques are worth correct understanding and objective assessment.
Two-hundred and forty-five eyes of 240 cases of branch retinal vein occlusion (BRVO) were analysed to determine the risk factors influencing the development of retinal neovascularization (NV).There were 208 eyes with major BRVO, 37 eyes with macular BRVO, 79 eyes with major BRVO developed NV, and the incidence of NV in this series was 37.9%.The incidence of vitreous hemorrhage in these eyes was 15.9%(39 eyes). The risk factors influencing the development of retinal NV in BRVO seem as follows: (]) the extent of retinal capillary nonperfusion area, (2)inefficiency of arterial infusion, (3) the extent of venous block at the arteriovenous crossing, (4) the duration of follow-up since onset of BRVO, and (5) the lack of collateral formation, Because BRVO has a long natural history, it is recommended that the patients should be followed-up for a long time If the vessels at peripheral retina closed, fluorescein angiography should be performed without hesitation and if the nonperfusion area is greater than 20-30 disc area, one should follow the patient carefully.As soon as the new vessels appear, laser photocoagulation should be applied without delay. （Chin J Ocul Fundus Dis,1994,10:67-70）
By using the different light stimuli, the flash ERG of 32 cases of central retinal vein occlusion(CRVO) (13 of ischemic type,19 of non-ischemic type) during acute phase were examined. The results showed that the a-wave and b-wave latency of CRVO elongated,while the b-wave amplitude of ischemie type decreased and that of non-ischemic type varied in different stimulus: decreased,increased or normal.Therefore,b-wave amplitude and b/a ratio,and selection of suitable ERG condition of stimulus are thought to be important in differetiating ischemic from non-ischemic CRVO. (Chin J Ocul Fundus Dis,1994,10:7-10）
The effect and opportunity of argon laser photocoagulation for the retinal neovascularization in branch retinal vein occlusion in 30 patients were investigated with a control group of 34 patients received nonlaser but routine treatment. The results of the therapeutic effect demonstrated that the neovascularization disappeared completely in 23 cases and became smaller in 7 cases after laser photocoagulation. The incidnce of vitreous hemorrhage in laser group was 43.3% before laser treatment and none after treatment in the duration of observation,and 70.6% in control group. The progression of visual acuity after treatment in laser group was much better than in control group(P＜0. 005)at the time of the latest examination. We found the therapeutic effect was relation to the area, location of the neovascularization in retina,as well as whether the new vessels protruding into vitreous or not. （Chin J Ocul Fundus Dis,1994,10:195-198）
Objective To investigate the relationship among central retinal vein occlusion (CRVO), major systemic diseases, ocular local diseases and related risk factors in Chinese population. Methods Seventeen-six patients with CRVO diagnosed by fundus fluorescein angiography (FFA) without any medical treatment were in CRVO group. Another 76 patients without CRVO or any vascular diseases of ocular fundus were in the control group who were matched with the ones in CRVO group to a one-to-one partnership according to the age and gender. The 2 groups were subdivided into le;45 years old (25 patients, 32.9%) and gt;45 years old (51 patients, 67.1%) subgroups according to the age, and 2 ischemia and non-ischema subgroups according to the results of FFA, respectively. The blood lipid, blood pressure, and fasting blood glucose were measured. The systematic diseases, ocular local diseases and the related risk factors were statistically analyzed and compared. Results The incidence of hypertension and hyperlipemia in CRVO group were significantly higher than that in the control group (Plt;0.001,P=0.001). There was no significant difference of cardiovascular diseases, cerebrovascular diseases, open-angle glaucoma, and smoking and drinking between the two groups(Pgt;0.05). In le;45 years old subgroups, there was no significant difference of each examination target between CRVO and control group(Pgt;0.05). In ischemia subgroups, except for the hypertension and hyperlipemia, the incidence of diabetes mellitus was obviously higher in CRVO group than that in the control group (hyperlipidemia:P=0.031; diabetes mellitus:P=0.024; diabetes mellitus: Plt;0.001). Conclusion Hypertension and hyperlipidemia are the systematic factors in Chinese population with occurrence of CRVO. In addition, diabetes mellitus is associated with ischemic CRVO. Timely diagnosis and treatment of the systematic diseases is important to the prevention and treatment for CRVO. (Chin J Ocul Fundus Dis, 2007, 23:159-162)
ObjectiveTo observe the long-term effects of anti-vascular endothelial growth factor (VEGF) drug initiation combined with dexamethasone intravitreal implant (DEX) on the structural integrity of the outer macular region of the eye in patients with macular edema (ME) secondary to central retinal vein occlusion (CRVO). MethodsA retrospective clinical study. From February 2018 to August 2022, 54 patients diagnosed with CRVO combined with ME (CRVO-ME) in Department of Ophthalmology of Central Theater Command General Hospital were included in the study. Among them, there were 30 males and 24 females, all with monocular disease. According to different treatment regiments, patients were divided into anti-VEGF and DEX combination therapy group (initial combination group), anti-VEGF drug monotherapy group (monotherapy group) with 21 eyes and 33 eyes, respectively. Best corrected visual acuity (BCVA), optical coherence tomography (OCT) examination were performed in all eyes. The thickness of foveal retina (CRT) and the deficiency length of outer membrane (ELM), ellipsoid band (EZ) and chimaera band (IZ) in the 1 mm macular area were measured by OCT. The initiating combination group was treated with anti-VEGF agents or DEX as assessed on demand (PRN) after the combination therapy, and the monotherapy group received 3+PRN regimen. Relevant examinations were performed at 1 (V1), 6 (V6), 12 (V12) months and observation cut-off or the last visit (Vf) after treatment using the same equipment before treatment. The deletion length of ELM, EZ and IZ in V1, V6, V12 and Vf after treatment were compared between the two groups. Repeated measurement ANOVA was used to compare BCVA, CRT and deletion length of ELM, EZ and IZ at different follow-up times. Spearman rank correlation test was used to analyze the correlation between the two groups of continuous variables. ResultsThe follow-up time of patients in the initial combination group and monotherapy group was (18.05±5.66) and (21.90±10.80) months, respectively, with no statistical significance (F=13.430, P=0.229). Compared with baseline, the deletion lengths of ELM, EZ and IZ were significantly improved (F=11.848, 10.880, 29.236), BCVA was increased (F=10.541) and CRT was decreased (F=52.278) in the initial combination group and the monotherapy group at different follow-up times after treatment. The differences were statistically significant (P＜0.001). At V1, EZ and IZ deletion lengths were (344.10±413.03), (593.33±372.96) μm and (354.71±321.75), (604.85±385.77) μm in the initial combination group and monotherapy group, respectively. The improvement of EZ and IZ deletion lengths in the initial combination group was better than that in the single drug group, and the difference was statistically significant (F=5.272, 6.106; P=0.026, 0.017). The CRT of the initial combination group and the monotherapy group were (248.86±59.99) and (314.72±214.91) μm, respectively, and the CRT of the initial combination group was significantly lower than that of the monotherapy group, with statistical significance (F=6.102, P=0.017). At V6, V12 and Vf, the deletion length of ELM, EZ and IZ and BCVA and CRT showed no statistical significance (P＞0.05). Correlation analysis showed that ELM, EZ, IZ were positively correlated with BCVA and CRT in the initial combination group and monotherapy group (P＜0.001). In V6, V12 and Vf, the number of anti-VEGF drug injections in the initial combination group and monotherapy group was (2.67±1.32), (4.43±2.27), (6.05±3.51), (4.58±0.90), (7.33±1.93), (11.33±6.10) times, respectively. The number of injections in the initial combination group was significantly lower than that in the monotherapy group, and the difference was statistically significant (F=5.150, 0.646, 3.433; P＜0.001). ConclusionsThe improvement of BCVA and CRT in the initial combination group is similar to that in the monotherapy group. Compared with the monotherapy group, EZ and IZ deletion are improved more significantly in the initial combination group, and CRT decreased more rapidly and significantly. The initial combination group receives fewer anti-VEGF injections than the monocular group.