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 observe the clinical features of retinal arterial occlusion (RAO) in youth.MethodsThis is a retrospective case review. Nine patients (9 eyes) with RAO were enrolled in this study. There were 6 males (6 eyes) and 3 females (3 eyes). The average age was (14.22±3.93) years. The best-corrected visual acuity (BCVA), indirect ophthalmoscopy, fundus color photography and fundus fluorescein angiography were performed. All patients underwent systemic evaluation including blood routine, erythrocyte sedimentation rate, blood lipids, vasculitis screening, homocysteine level, antiphospholipid antibody, blood coagulation, neck vascular ultrasound, and cardiac color ultrasound and electrocardiogram examination. All patients received oxygen therapy, blood medications and symptomatic treatment. Meanwhile, the patients with autoimmune diseases were received systemic glucocorticoid therapy. The follow-up was ranged from 6 to 12 months. The visual acuity and fundus change before and after treatment were compared.Resultsamong 9 patients, one patient had systemic lupus erythematosus, one patient had congenital heart disease, one patient had hypergammaglobulinemia, and carotid artery color ultrasonography showed that the internal carotid artery vessels faltered in 2 cases. The BCVA was 0.01 - 0.12. Among 9 eyes, there were 5 eyes (55.6%) with retinal branch artery occlusion (BRAO), 2 eyes (22.2%) with central retinal artery occlusion (CRAO), 2 eyes (22.2%) with ciliary retinal artery occlusion (CLAO). CRAO eyes showed positive RAPD (relative afferent pupillary defect), fine retinal artery and the corresponding vein, pale white retinal edema in posterior area and macular cherry-red spot. BRAO eyes manifested as inferior temporal artery occlusion and pale white retinal edema around them. CLAO eyes showed temporal ligulate grey-white retinal edema. At the last follow-up, BCVA improved and retinal vessels returned to normal in 7 eyes (77.8%); BCVA unchanged and no improvement in fundus in 2 eyes (22.2%).ConclusionAdolescent RAO is mostly partial occlusion, the prognosis is generally good after early active treatment.
Objective To investigate the clinical effect of the one-stage arteriovenous shunt on the extensive arterial ischemic disease of the lower extremities. Methods The one-stage arteriovenous shunts in the lower extremities were applied to 90 patients with extensive arterial ischemic diseases, including arterial occlusive disease (AODs,62 patients) and thromboangiitis obliterans (TAOs,28 patients). By the retrospective analysis on the clinical materials and the follow-up of the postoperative patients, the immediate and the longterm surgical outcomes were summarized. Results During the hospitalization, 88 patients achieved a remarkable surgical effectiveness, with an immediate surgical effectiveness rate of 97.7% (88/90), but 2 patients failed in the operation and had to undergo amputation of the lower limb. Of the 72 patients who were followed up for 0.5-5 years after the arteriovenous shunt operation, 64 could have a sufficient blood supply to the lower extremities, with a longterm effectiveness rate of 88.9% (64/72); however, 8 patients had to undergo transplantation of the greater omentum or amputation of the lower limb. Conclusion The one-stage arteriovenous shunt performedon the lower extremities for an extensive arterial ischemic disease is a simpler and more effective surgical protocol for reconstruction of the circulation of the patient who is not suitable for the operation of arterial bypass.
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)
Retinal vein occlusion (RVO) is one of the most common retinal vascular diseases causing blindness, macular edema (ME) is often secondary to it, which causes serious visual impairment to patients. Imaging biomarkers in the changes of retina and choroid of ME secondary to RVO (RVO-ME) have important clinical value in the evaluation of condition, curative effect and visual acuity prediction of patients with RVO-ME. Among them, the disorganization of the retinal inner layers, the integrity of external limiting membrane and ellipsoid zone, and the change of central macular thickness are reliable indexes to evaluate the prognosis of visual acuity; hyperreflective foci, subretinal fluid and intraretinal fluid can be used as important parameters to reflect the level of inflammation; prominent middle limiting membrane and paracentral acute middle maculopathy are the objective basis for judging the degree of retinal ischemia; the changes of choroidal vascular index and choroidal thickness also have potential advantages in evaluating the progress of the disease. Accurately grasp the characteristics of biological markers of RVO-ME related optical coherence tomography is conducive to its reasonable and accurate use in the clinical diagnosis and treatment of RVO-ME, and helpful to further explore the pathogenesis of the disease.
Retinal vein occlusion (RVO) is one of the most important retinal vascular diseases in China that leads to severe loss of vision. In recent years, the emergence of various emerging imaging technologies and new drugs has not only deepened our understanding of the natural course of this disease, but also significantly changed the traditional treatment mode of retinal laser photocoagulation as the gold standard, thereby significantly improved the visual prognosis. However, currently in various regions and levels of hospitals in China, the diagnosis and treatment of RVO still rely mainly on their own experience. The awareness and knowledge of RVO among ophthalmologists in various regions still need to be improved. A standardized clinical diagnosis and treatment pathway is needed in order to meet the needs of most RVO patients. Led by the Fundus Disease Group of the Ophthalmology Branch of the Chinese Medical Association and the Fundus Disease Professional Committee of the Ophthalmology Branch of the Chinese Medical Association, based on the existing evidence-based evidence at home and abroad, and following the principles of consensus formulation, Expert consensus on clinical diagnosis and treatment path of retinal vein occlusion in China has been compiled. The consensus systematically and comprehensively elaborated a standardized diagnosis and treatment pathway for RVO. Interpreting the key points in this consensus is helpful to highlight the core ideas, and improve the utilization of this consensus by ophthalmologists from all levels of hospitals.
Objective To evaluate the efficacy and safety of dexamethasone intravitreal implant (Ozurdex) in the treatment of macular edema (ME) secondary to retinal vein occlusion (RVO). Methods Thirty-nine patients (39 eyes) with ME secondary to RVO were enrolles in this study. Of the patients, 27 were male and 12 were female. The mean age was (41.9±16.3) years. The mean course of disease was (5.0±5.3) months. The best corrected visual acuity (BCVA), intraocular pressure and optical coherence tomography (OCT) were performed. BCVA was measured by Early Treatment Diabetic Retinopathy Study charts. Central macular thickness (CMT) was measured by OCT. The mean BCVA was (13.4±15.3) letters. The mean intraocular pressure (IOP) was (14.1±2.8) mmHg (1 mmHg=0.133 kPa). The mean CMT was (876.1±437.9) μm. Of the 39 eyes, 33 were central RVO, 6 were branch RVO. Patients were categorized into ischemic (18 eyes)/non-ischemic (21 eyes) groups and previous treatment (22 eyes)/treatment naïve (17 eyes) groups. All eyes underwent intravitreal 0.7 mg Ozurdex injections. BCVA, IOP and CMT were assessed at 1, 2, 3, 6, 9, 12 months after injection. Three months after injection, intravitreal injections of Ozurdex, triamcinolone acetonide or ranibizumab could be considered for patients with ME recurrence or poor treatment effects. Change of BCVA, IOP and CMT were evaluated with paired t test. The presence of ocular and systemic adverse events were assessed. Results BCVA, IOP significantly increased and CMT significantly decreased at 1 month after injection compared to baseline in all groups (t=3.70, 3.69, 4.32, 3.08, 4.25, 6.09, 6.25, 4.02, 5.49, 8.18, 6.54, 5.73; P＜0.05). Two months after injection, change of BCVA, IOP and CMT was most significant (t=4.93, 6.80, 6.71, 5.53, 4.97, 5.89, 5.13, 7.68, 7.31, 8.67, 8.31, 5.82; P＜0.05). Twelve months after injection, there was no statistical difference regarding BCVA of ischemic RVO group and previous treatment group, compared to baseline (t=1.86, 0.67; P＞0.05); BCVA of non-ischemic RVO group and treatment naïve group significantly increased compared to baseline (t=2.27, 2.30; P＜0.05); there was no statistical difference regarding IOP in all groups (t=0.30, 0.13, 0.64, 1.53; P＞0.05);however, CMT significantly decreased in all groups (t=4.60, 3.26, 3.00, 4.87; P＜0.05). Twenty-seven eyes (69.2%) experiences ME recurrence (4.5±1.5) months after injection. Most common side-effect was secondary glaucoma. 41.0% eyes had IOP more than 25 mmHg, most of which were lowered to normal range with use of topical IOP lowering drugs. Four eyes (10.3%) presented with significant cataract progression and needed surgical treatment, all were central RVO eyes. No serious ocular or systemic adverse events such as vitreous hemorrhage, retinal detachment or endophthalmitis were noted. Conclusions Intravitreal injection of Ozurdex for patients with ME secondary to RVO is effective in increasing BCVA and lowering CMT in the first few months. Significant treatment effect could be seen at 1 month after injection and was most significant at 2 months after injection. The long-term vision of eyes in non-ischemic RVO group and treatment naïve group are better. 69.2% eyes experience ME recurrence at 4 months after injection. Short term adverse events were mostly secondary glaucoma and long term adverse events are mostly cataract progression.
Objective To evaluate the efficacy and safety of transthoracic minimally invasive occlusion operation for the treatment of congenital atrial and ventricular septal defects. Methods The clinical data of 88 patients who underwent surgical occlusion operation from December 2015 to February 2017 were summarized. There were 52 males and 36 females, aged 6.8±7.5 years ranging from 1.6 to 24.0 years. All the patients were followed up by ultrasound and electrocardiogram at postoperative 3, 6 and 12 months. The efficacy of minimally invasive thoracotomy was analyzed by statistical methods. Results The patients were followed up for 3-15 (6.8±2.3) months, and the follow-up rate was 92.0%. Ultrasound showed occluder fixed well and no residual shunt, valve regurgitation, thrombosis or other complications occurred. The heart was reduced, the ejection fraction was greater than 55%, and heart function rating for all patients was grade Ⅰ. Conclusion Transthoracic mini-invasive surgical occlusion of atrial and ventricular septal defects is safe and effective. The short and middle-term effect is satisfying. It can be widely used in clinical, but multi-center and long-term follow-up and assessment still need to be carried out.
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.
Retinal vein occlusion (RVO) is a vascular disease characterized by intraretinal hemorrhage, edema and hard exudation, which is caused by increased retinal vein pressure. OCT angiography (OCTA) has been widely used in the diagnosis of retinal vascular diseases including RVO by virtue of non-invasive, high resolution and stratified display of superficial, deep retinal vessels and quantification of retinal vessel density and non-perfusion area size. OCTA can provide information of retinal microvascular structure and blood perfusion under the condition of disease, it also can be used to evaluate the effect of treatment and changes of retinal circulation during the course of disease follow-up. Although OCTA cannot replace fundus angiography completely, it has brought us more information about the pathogenesis, disease progression and prognostic factors of RVO. It is believed that with the progress of technology, OCTA will bring us a new chapter in the study of retinal vascular diseases including RVO.