Objective To explore the clinical application value of multifocal oscillatory potentials (MOPs) in retinal vein occlusion (RVO). Methods MOPs were tested using VERIS 4.0 visual evoked response imaging system for 19 cases (19 eyes) of RVO，among them 8 cases of central retinal vein occlusion (CRVO) and 11 cases of branch retinal vein occlusion (BRVO). Twenty normal subjects were as normal control group. The stimulative visual angles subtended ±26.6°horizontally and ±22.1°vertically. The filter setting was bandpass 100～1000 Hz. The retinal responses from 103 hexagons were recorded in 4 min (8 segments). Results In normal control group, OP-1, OP-2 and OP-3 were recorded during 37 ms for first order and 47 ms for second order first slice in whole test field and 5 ring retinal regions, the oscillatory wave shapes of second order were clearer than those of first order. In RVO groups, 91.6% latencies of OP-1, OP-2 and OP-3 were delayed, and 70.8% amplitudes of OP-1, OP-2 and OP-3 were reduced. The delay of the latencies and the decrease of the amplitude in CRVO were more markedly than those in BRVO. Conclusion MOPs can be effectively and quantitatively used to evaluate the retinal function of the different location in RVO. (Chin J Ocul Fundus Dis,2002,18:20-22)
Objective To investigate the clinical characteristic of ocular fundus complications in systemic lupus erythematosus (SLE). Methods In 25 cases of SLE with the ocular fundus complications, the ocular fundus, the other ocular tissues, general lesions，and antinuclear antibody (ANA ), anti-double-stranded DNA（anti-dsDNA）, complement 3 (C3), complement 4 (C4)and erythrocyte sedimentation rate(ESR) were analyzed retrospectively. Results In the 25 cases, “classic” SLE retinopathy in 15 (25 eyes), retinal vein occlusion (RVO) in 9 (12 eyes), RVO combined with retinal arter y occlusion in 1 (2 eyes), exudative retinal detachment in 1 (2 eyes), vitreous hemorrhage combined with neovascular glaucoma in 1 (1 eye), and optic discedem a except RVO in 3 (6 eyes) were found. Nine cases accompanied with other ocular signs and 21 with general lesions. Positive ANA and anti-dsDNA and elevated ESR in all of the patients, decreasing C3 in 19, and C4in 17 were found.Conclusions SLE can cause serious ocular fundus complications accompanied with other ocular signs. Regular ophthalmic examination should be performed on the patients with SLE to detect and treat the ocular complications promptly. (Chin J Ocul Fundus Dis，2004，20：206-208)
Macular edema is a common cause of visual loss in patients with retinal vascular diseases represented by diabetic retinopathy and retinal vein occlusion. Laser photocoagulation has been the main treatment for this kind of diseases for decades. With the advent of antagonist of vascular endothelial growth factor and dexamethasone implant, diabetic macular edema and macular edema secondary to retinal vein occlusion have been well controlled; the use of laser therapy is decreasing. However, considering possible risks and complications, lack of extended inspection of efficacy and safety of intravitreal pharmacotherapy, laser therapy cannot be replaced by now. Therefore, the efficacy and safety of laser therapy will improve by sober realization of role of photocoagulation and proper selection of treatment indication.
ObjectiveTo investigate the efficacy and safety of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to branch retinal vein occlusion (BRVO) during one year period. MethodsThe data of 31 eyes from 31 consecutive patients with macular edema secondary to BRVO during one year follow-up visit were retrospectively analyzed. Mean best corrected visual acuity (BCVA) logMAR was (0.74±0.36) and mean central retinal thickness (CRT) was (484.48±164.81)μm at baseline. All patients received standardized clinical comprehensive examinations including vision, intraocular pressure and optical coherence tomography for diagnosis before treatment. All patients received intravitreal injections of 0.5 mg ranibizumab (0.05 ml) at first visit. The continue PRN treatment were based on the visual acuity changes and the optical coherence tomography findings. Eyes received combined triamcinolone acetonide 0.05 ml (40 mg/ml) and ranibizumab for macular edema recurrence after two injections of ranibizumab and received laser photocoagulation during 10-14 days after third injections of ranibizumab. Mean injection of ranibizumab was 3.52±2.01, 15 eyes with triamcinolone acetonide (0.84±1.21), 21 eyes with laser photocoagulation (0.97±0.95) and 12 eyes with three treatment. Compared the visual acuities and CRTs of the first and the last visits by statistical analysis. ResultsMean visual acuity improved significantly to 0.42±0.33 logMAR (t=6.611, P=0.000). Mean improvement of visual acuity was 2.90±3.07 lines. A gain of three or more logarithmic lines was evaluated in 20/31 eyes (64.52%) at the last visit. Mean CRT was (326.19±117.80)μm (t=4.514, P=0.000).Mean reduction of CRT was (333.58±134.17)μm. A decrease of 100μm of CRT was evaluated in 17/31 eyes (54.84%). No severe ocular and systematic side effect was found. ConclusionThe efficacy and safety of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to BRVO were assured.
Purpose To evaluate the significance of axial length in case of branch retinal vein occlusion(BRVO). Methods A case-control study of axial length was performed using 34 patients with BRVO and 34 age and sex-matched control patients selected from a list of subjects who had undergone cataract extraction.Axial length measurement were taken with an A-scan ultrasonography. Results The affected and fellow eye in patinets of BRVO group did not differ statistically in axial length (P＞0.20).The mean axial length of affected eyes in BRVO group was （23.16plusmn;0.82）mm, and the mean axial length of control eyes was（23.78plusmn;1.06）mm.The difference in axial length between the eyes with BRVO and the eyes in the control group was not statistically significant(P＞0.10). Conclusion Hyperopia as measured by axial length is not a risk factor to BRVO. (Chin J Ocul Fundus Dis,1998,14:12-13)
ObjectiveTo study a deep learning-based dual-modality fundus camera which was used to study retinal blood oxygen saturation and vascular morphology changes in eyes with branch retinal vein occlusion (BRVO). MethodsA prospective study. From May to October 2020, 31 patients (31 eyes) of BRVO (BRVO group) and 20 healthy volunteers (20 eyes) with matched gender and age (control group) were included in the study. Among 31 patients (31 eyes) in BRVO group, 20 patients (20 eyes) received one intravitreal injection of anti-vascular endothelial growth factor drugs before, and 11 patients (11 eyes) did not receive any treatment. They were divided into treatment group and untreated group accordingly. Retinal images were collected with a dual-modality fundus camera; arterial and vein segments were segmented in the macular region of interest (MROI) using deep learning; the optical density ratio was used to calculate retinal blood oxygen saturation (SO2) on the affected and non-involved sides of the eyes in the control group and patients in the BRVO group, and calculated the diameter, curvature, fractal dimension and density of arteriovenous in MROI. Quantitative data were compared between groups using one-way analysis of variance. ResultsThere was a statistically significant difference in arterial SO2 (SO2-A) in the MROI between the affected eyes, the fellow eyes in the BRVO group and the control group (F=4.925, P<0.001), but there was no difference in the venous SO2 (SO2-V) (F=0.607, P=0.178). Compared with the control group, the SO2-A in the MROI of the affected side and the non-involved side of the untreated group was increased, and the difference was statistically significant (F=4.925, P=0.012); there was no significant difference in SO2-V (F=0.607, P=0.550). There was no significant difference in SO2-A and SO2-V in the MROI between the affected side, the non-involved side in the treatment group and the control group (F=0.159, 1.701; P=0.854, 0.197). There was no significant difference in SO2-A and SO2-V in MROI between the affected side of the treatment group, the untreated group and the control group (F=2.553, 0.265; P=0.088, 0.546). The ophthalmic artery diameter, arterial curvature, arterial fractal dimension, vein fractal dimension, arterial density, and vein density were compared in the untreated group, the treatment group, and the control group, and the differences were statistically significant (F=3.527, 3.322, 7.251, 26.128, 4.782, 5.612; P=0.047, 0.044, 0.002, <0.001, 0.013, 0.006); there was no significant difference in vein diameter and vein curvature (F=2.132, 1.199; P=0.143, 0.321). ConclusionArterial SO2 in BRVO patients is higher than that in healthy eyes, it decreases after anti-anti-vascular endothelial growth factor drugs treatment, SO2-V is unchanged.
ObjectiveTo observe the correlation analysis between the deep-superficial flow-density ratio (DSFR) and treatment response of macular edema secondary to branch retinal vein occlusion (BRVO).MethodsForty-eight patients（48 eyes）with macular edema secondary to BRVO from December 2018 to December 2019 in the Department of Ophthalmology of Beijing Hospital were enrolled in this study. There were 29 males (29 eyes) and 19 females (19 eyes), with the mean age of 58.77±10.88 years. All eyes were treated with intravitreal injection of ranibizuma once a month for 3 months, and then treated as needed. According to the central retinal thickness (CRT) 12 months after treatment, the patients were divided into good response group (CRT≤250 μm) and refractory group (CRT＞250 μm). The flow density in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) of all subjects was measured by optical coherence tomography angiography. The flow density of DCP and SCP measured at 3 follow-up times was selected and DSFR was calculated. The DSFR was recorded by the Study for the Treatment of Diabetic Retinopathy (ETDRS) -grid and Nine-grid. The flow density of DCP, SCP and DSFR were compared between the two groups by paired t test. At 3 months post-treatment, the efficacy of DSFR in ME treatment response was evaluated according to area under curve (AUC) of receiver operating characteristic. Univariate and multivariate binary logistic regression were used to analyze the factors affecting the response to ME treatment.ResultsAt 12 months after treatment, there were 27 eyes in good response group and 21 eyes in refractory group. There was no statistical significance in the flow density of DCP (t=1.804, 1.064, 0.660) and SCP (t=0.581, 0.641, 0.167) and DSFR (t=0.393、－0.553、0.474) in all area of response group and refractory group using ETDRS-GRID recording method (P＞0.05). The SCP, DCP and DSFR of the most severe non-perfusion area were (27.10±5.70) %, (28.33±8.95) %, 1.35±0.54 and (27.54±6.70) %, (29.11±0.42) %, 1.01±0.40 in the response group and refractory group, respectively. There was no significant difference in the flow density of DCP and SCP between the two groups (t=－0.237, －0.340; P＞0.05). The difference of DSFR between two groups was statistically significant (t=2.288, P=0.024). Univariate and multivariate binary logistic regression analysis showed that DSFR in the most severe non-perfusion area was associated with ME response (odds ratio=0.212, 0.085; P=0.027, 0.024). The AUC was used to evaluate the efficacy of DSFR in ME treatment response, the results showed that the AUC was 0.800, P=0.001, Youden index was 1.348, sensitivity was 67.7%, and specificity was 86.7%.ConclusionsDSFR reduction is more common in BRVO secondary to ME patients. DSFR correlates with ME treatment response.
Objective lt;brgt;To inspect the rate of success of anastomosis and tissue damage with different power levels of photocoagulation in the treatment of experimental branch retinal vein occlusion (BRVO) by laser induced chorioretinal venous anastomosis. lt;brgt;Methods lt;brgt;Forty pigmented rabbits (80 eyes) were divided into four groups in random, and 10 (20 eyes) in each. Chroioretinal venous anastomosis was attempted to create using the krypton red laser with 4 different power levels (group A: 400 mW,group B: 600 mW,group C: 800 mW,group D: 1000 mW) in these animals in which BRVO had previously been created photodynamically. Fundus photography and fundus fluorescein angiography were performed at various times after the treatment and histological examination was taken at the end of the study. lt;brgt;Results lt;brgt;The model of BRVO was successfully set up. At the lowest power of 400 mW there was an absence of anastomosis formation and the damage to the retina and choroid was mild, Bruch′s membrane showed no evidence of rupture. At the power levels of 600 mW and 800 mW an anastomosis formed in 15% and 55% respectively and the damage was medium in degree. At the highest power level of 1 000 mW a 80% rate of success was obtained, however, the damage to the retina and choroid tended to be severe.The difference of the rate of success of anastomosis between different groups was highly significant (P=0.001), the difference between group B and group C was also highly significant (PBC=0.008), and the difference between group A and group B, group C and group D was not significant (PAB=0.072、PCD=0.091). lt;brgt; lt;brgt;Conclusion lt;brgt;The optimal power level of krypton red laser induced chorioretinal venous anastomosis is 800 mW, 0.1 s, 50 μm in our study. lt;brgt; lt;brgt;(Chin J Ocul Fundus Dis,2002,18:13-16)
Objective To observe the changes of macular microvascular structure and macular pigment density (MPOD) in eyes with macular edema (ME) secondary to retinal vein occlusion (RVO), and preliminarily analyze their correlation. MethodsA prospective clinical study. A total of 62 eyes of 62 patients with monocular RVO secondary ME (RVO-ME) diagnosed in the Ophthalmology Hospital of Xi'an No.1 Hospital from July 2020 to May 2021 were included in this study. There were 33 males with 33 eyes, 29 females with 29 eyes. The age was 58.30±12.15 years. The course of disease from the onset of symptoms to medical treatment was 12.29±7.65 days. All patients underwent best corrected visual acuity (BCVA), optical coherence tomography angiography (OCTA) and MPOD test. BCVA examination was performed using a standard logarithmic visual acuity chart, which was converted to logarithm of minimum angle of resolution (logMAR). The vascular density (VD), vascular skeletal density (SD), foveal avascular area (FAZ) and central macular thickness (CMT) of the superficial retinal capillary plexus (SCP) in the range of 3 mm×3 mm in the macular area of bilateral eyes were measured by OCTA. MPOD was measured by heterochromatic scintillation photometry. Bilateral eyes passed examination in 37 cases. The eyes of 25 patients failed to pass the test. The changes of macular VD, SD, FAZ area, CMT and MPOD between the affected eyes and the contralateral eyes were compared. The MPOD of the affected eye and the contralateral eye was compared by paired t test. FAZ area, CMT, VD, SD, and logMAR BCVA were tested by paired Wilcoxon signed rank sum test. Spearman rank correlation test was used to analyze the correlation between macular blood flow density (VD, SD) and foveal morphology (FAZ area, CMT) with logMAR BCVA and MPOD. ResultsCompared with contralateral eyes, VD (Z=－5.981) and SD (Z=－6.021) were decreased, FAZ area (Z=－2.598) and CMT (Z=－6.206) were increased, and the differences were statistically significant (P＜0.05). In 37 patients who passed MPOD test in bilateral eyes, the MPOD value of the affected eye was lower than that of the contralateral eye, and the difference was statistically significant (t=－2.930, P＜0.05). Compared with the affected eye which failed to pass the MPOD detection, macular VD (Z=－2.807) and SD (Z=－2.460) were increased, FAZ area (Z=－4.297) and CMT (Z=－3.796) were decreased in the affected eye which passed the MPOD test, and the differences were statistically significant (P＜0.05). Correlation analysis showed that logMAR BCVA in the affected eye was negatively correlated with macular VD and SD (r=－0.298, －0.461; P＜0.05), which was positively correlated with FAZ area and CMT (r=0.487, 0.789; P＜0.05). MPOD in the affected eye was negatively correlated with logMAR BCVA (r=－0.344, P＜0.05). MPOD in the contralateral eye was positively correlated with CMT (r=0.358, P＜0.05). ConclusionsThe VD and SD of macular SCP are decreased, FAZ area is enlarged, CMT is thickened, and MPOD is decreased in RVO-ME eyes. MPOD is negatively correlated with logMAR BCVA.
Objective To evaluate the correlation between antiphospholipid (APLA) antibodies and retinal vein occlusion (RVO). Methods A computerized search was conducted in the Pubmed, Chinese Biological Medicine Database, China National Knowledge Infrastructure, VIP database, Wanfang Database combined with manually searching of literature reference proceedings. The search time was ranged from establishment of each database to August 1st, 2012. After the data extraction, quality of RCT was assessed. The meta analysis was performed by Stata 11.0. Results In total, 12 case-control studies (1324 subjects) that fulfilled the eligibility criteria were included in the meta-analysis involving 505 patients in RVO group and 819 subjects in control group. The odds ratio (OR) and 95% confidence interval (CI) of APLA, anticardiolipin antibodies (ACA), lupus coagulation inhibitor and RVO were 5.01 and 3.33 - 7.53,4.38 and 2.38 - 8.05, 1.72 and 0.73 - .88, 6.02 and 2.06 - 17.63, respectively. The OR and 95% CI of APLA, ACA, lupus coagulation inhibitor and branch RVO were 4.22 and 1.67 - 10.63, 3.69 and 1.32 - 10.32, 2.07 and 0.79 - 5.41, respectively. Conclusions APLA may increase the rick of RVO, especially ACA has a prediction function to RVO. It is necessary to screening for APLA in RVO patients.