Branch retinal artery occlusion (BRAO) and branch retinal vein occlusion (BRVO) rarely cause neovascular glaucoma (NVG). A 58-year-old woman with hypertension and type 2 diabetic mellitus complained of progressive visual loss in her right eye for the previous 3 months. At initial examination, visual acuity was 20 / 63 in the right eye. Angle neovascularization was observed and the intraocular pressure (IOP) was 30 mmHg in her right eye. Fundus examination and fluorescein angiography showed BRAO combined with BRVO. We immediately injected intravitreal and intracameral bevacizumab in her right eye. The next day, we performed scatter photocoagulation in the nonperfusion area. One month later, visual acuity was 20 / 20 in her right eye and the IOP was 17 mmHg with one topical antiglaucoma agent. The neovascularization had regressed completely. We report a case of unilateral NVG which was caused by BRAO with concomitant BRVO and advise close ophthalmic examination of the iris and angle in BRVO with BRAO.
Diagnosis, Differential ; Female ; Fluorescein Angiography ; Fundus Oculi ; Glaucoma, Neovascular/diagnosis/*etiology/physiopathology ; Humans ; Intraocular Pressure ; Middle Aged ; Retinal Artery Occlusion/*complications/diagnosis ; Retinal Vein Occlusion/*complications/diagnosis

Diabetic Retinopathy ; complications ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Retinal Vein Occlusion ; complications ; Vitrectomy ; Vitreous Hemorrhage ; etiology ; surgery

The branch retinal vein occlusion is the second most common retinal vascular disease after diabetic retinopathy. Complications such as macular edema, retinal neovascularization, vitreous hemorrhage, epiretinal membrane may be associated. But, the retinal detachment may occur rarely in BRVO patients. We studied the clinical features of retinal detachment associated with branch retinal vein occlusion. We reviewed the medical records of 15 retinal detachment patients associated with branch retinal vein occlusion. Mean age was 54.7 years old and 10 patients(66.7%) were female. Hypertension was associated in 13cases(86.7%). The duration between the development of BRVO and the development of retinal detachment was shorter than 4 years in all cases and shorter than 2 years in 9 cases(60.0%). Retinal break was identified in 14 cases(93.3%), among which 13 cases(92.2%) were located inside the lesion of branch vein occlusion. The epiretinal membrane was frequently combined 8 cases(53.3%). The preoperative laser photocoagulation was done in 4 cases(26.7%). The primary surgical procedures included scleral buckling in 8 cases(53.3%), pars plana vitrectomy in 6 cases(40.0%), and scleral buckling with pars plana vitrectomy in 1 case(6.7%). Three cases(20.0%) required reoperations. The postoperative complications included the progression of cataract in 6 cases(40.0%), iatrogenic retinal tear in 3 cases(20.0%), epiretinal membrane in 2 cases(13.3%), and proliferative vitreoretinopathy in 1 case(6.7%). The anatomic retinal reattachment was achieved in 14 cases(93.5%) and the visual recovery in 11 cases(73.3%).
Cataract ; Diabetic Retinopathy ; Epiretinal Membrane ; Female ; Humans ; Hypertension ; Light Coagulation ; Macular Edema ; Medical Records ; Postoperative Complications ; Retinal Detachment* ; Retinal Neovascularization ; Retinal Perforations ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Scleral Buckling ; Vascular Diseases ; Veins ; Vitrectomy ; Vitreoretinopathy, Proliferative ; Vitreous Hemorrhage

PURPOSE: To analyze the effects and the stability of a posterior capsulectomy during combined vitrectomy and cataract surgeries in patients with retinal disease. METHODS: Between 2003 and 2005, the records of patients who underwent posterior capsulectomy during a combined vitrectomy and cataract surgery were followed for 12 months. Among 26 total eyes (17 were from males and nine from females), the average age was 63. An epiretinal membrane was found in 18 eyes, branch retinal vein occlusion in three eyes, diabetic macular edema and vitreous opacity in two eyes, and a macular hole in one eye. The posterior capsulotomy was made smaller than the optic using a vitrectomy cutter after insertion of a posterior chamber intraocular lens (IOL). We investigated postoperative visual acuity, inflammation, and complications. RESULTS: There were no intraoperative complications. One month postoperatively, one eye (3.8%) showed an increase in intraocular pressure of more than 30 mmHg, one eye (3.8%) showed 2+ inflammatory cells in the anterior chamber. Visual acuity increased by 2 lines postoperatively in 13 eyes (50.0%), whereas visual acuity decreased by more than 1 line in one eye (3.8%). There was a slight decenteration of IOL within 1 mm in two eyes (7.7%) and there was no reclosure of the posterior capsulectomy one year postoperatively. CONCLUSIONS: Posterior capsulectomy during combined vitrectomy and cataract surgery in patients with retinal disease was simple, safe, and effective in preventing after cataract.
Anterior Chamber ; Cataract* ; Epiretinal Membrane ; Humans ; Inflammation ; Intraocular Pressure ; Intraoperative Complications ; Lenses, Intraocular ; Macular Edema ; Male ; Posterior Capsulotomy ; Retinal Diseases ; Retinal Perforations ; Retinal Vein Occlusion ; Visual Acuity ; Vitrectomy*

Primary antiphopholipid syndrome (APS) is a disease producing vascular thrombus with antiphospholipid antibody without association with autoimmune diseases as systemic lupus erythematosus. Retinal vein occlusion is a rare vascular manifestation in primary APS. We describe 2 cases of primary APS presenting with developing blurred vision. Each had central retinal vein occlusion and high titer of IgG anticardiolipin antibody.
Adult ; Antibodies, Anticardiolipin/analysis ; Antiphospholipid Syndrome/*complications/immunology ; Case Report ; Human ; Male ; Middle Age ; Retinal Vein Occlusion/*etiology/immunology

To investigate the retinal hemodynamics in branch retinal vein occlusion (BRVO), we measured retinal circulation times using scanning laser ophthalmoscope (SLO) and studied their relationships with clinical findings. Arm-retina time (ART) and arteriovenous passage time (AVP) were measured in 30 eyes of 30 patients. Mean ART was 13.07 seconds. ART showed no difference in relation to sex and systemic diseases, but increased with age. Mean AVPs were 3.00 sec. and 3.39 sec. in superotemporal and inferotemporal BRVO, respectively. AVPs were delayed significantly in occluded branch of retinal veins. AVP was delayed three-fold when the area of capillary nonperfusion was over 6 disc area, but showed no difference according to the duration of disease or macular edema. These results suggest that SLO may be a useful tool for studying retinal hemodynamics in BRVO.
Adult ; Aged ; Blood Circulation ; Female ; Humans ; Lasers/diagnostic use ; Male ; Middle Aged ; Ophthalmoscopes ; Regional Blood Flow ; Retinal Vein Occlusion/complications/*physiopathology ; Retinal Vessels/*physiology

The aim of this study is to elucidate the association of neovascularization in branch retinal vein occlusion (BRVO) combined with major arterial insufficiency (MAI), compared with BRVO alone. The authors retrospectively reviewed the charts, color photographs, and fluorescein angiograms of 304 patients (308 eyes) who had BRVO from 1990 to 2002 at Hanyang University hospital. Patients with BRVO combined with MAI and patients with BRVO alone were differentiated by angiographic appearance. Of the 308 eyes, 12 (3.9%) had neovascularization, all of which were in the 56 eyes of the MAI group for which the neovascularization rate was 21.4%. Neovascularization in BRVO was more strongly associated with the non-perfusion caused by MAI, rather than with the extent of the non-perfusion area that originated from retinal capillary obstruction. MAI is considered as a risk factor for neovascularization and hence could be a prognostic factor.
Adult ; Aged ; Comparative Study ; Female ; Fluorescein Angiography ; Humans ; Male ; Middle Aged ; Retinal Artery/*physiopathology ; Retinal Diseases/*complications/physiopathology ; Retinal Neovascularization/diagnosis/*etiology/physiopathology ; Retinal Vein Occlusion/*complications/diagnosis/physiopathology ; Retrospective Studies

PURPOSE: To evaluate long-term visual outcome of arteriovenous adventitial sheathotomy in BRVO-induced macular edema. METHODS: The visual outcomes of 8 patients following vitrectomy with arteriovenous adventitial sheathotomy for BVO-induced macular edema (surgery group) were retrospectively evaluated. The three-year post-operative visual acuity of the surgery group was compared with that of the conservatively managed controls. RESULTS: All patients were followed for a minimum of 36 months. Mean BCVA (logMAR) in the surgery group changed from 1.10+/-0.34 to 1.19+/-0.70 and to 0.80+/-0.36 at 12 and 36 months, respectively (p=0.959 at 12 months, p=0.018 at 36 months). In the control group, visual acuity improved from 1.15+/-0.43 to 0.43+/-0.44 and to 0.43+/-0.39 at 12 and 36 months, respectively (p=0.015 at 12 months, at p=0.003 at 36 months). A strong trend toward better visual acuity at 12 months and final examination was observed for controls. (surgery vs. control group, p=0.052 at 12 months, p=0.066 at 36 months). CONCLUSIONS: Considering the favorable natural course of BVO and the unproven effect of reperfusion on macular edema, surgical efficacy of arteriovenous adventitial sheathotomy requires further evaluation.
Aged ; Connective Tissue/*surgery ; Decompression, Surgical/methods ; Female ; Humans ; Macular Edema/etiology/physiopathology/*surgery ; Male ; Middle Aged ; Retinal Artery ; Retinal Vein ; Retinal Vein Occlusion/complications/physiopathology/*surgery ; Retrospective Studies ; Treatment Outcome ; Visual Acuity/*physiology ; Vitrectomy/*methods

PURPOSE: To examine the clinical effect of combination method of laser treatment and intravitreal triamcinolone (TA) injection for patient of macular edema with branched retinal vein occlusion (BRVO). METHODS: fifteen patients, -(15 eyes), 7 malse and 8 females, with macular edema associated with BRVO were included in the study. The mean age was 59.47 years old. The response to treatment was monitored functionally by visual acuity assessment and anatomically by Optical Coherence Tomography(OCT) for macular thickness. Four milligrams of TA were injected into the vitreous cavity. The clinical outcome and complication were reviewed, retrospectively. RESULTS: After the combination method of laser treatment and intravitreal TA injection, 13 (87%), 12 (80%), 13 (87%) of the 15 eyes showed improved the mean visual acuity at 1-, 2-, and 6-month follow-ups retrospectively. Central macular thickness as measured by OCT decreased by 37% (312.5 +/- 9 micrometer), 42% (282.1 +/- 556 micrometer), and 56% (276.9 +/- 76 micrometer), at the same follow-ups from an initial pretreatment mean of 495.9 +/- 114 micrometer. The post-operative complications were intraocular pressure elevation (1 eye, 7%), and cataract (3 eyes, 20%). However, there were no serious postoperative complication such as retinal detachment, vitreous hemorrhage, and endophthalmitis. CONCLUSIONS: The combination method of laser treatment and intravitreal TA injection may be useful for treating patient of macular edema with BRVO.
Cataract ; Endophthalmitis ; Female ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Macular Edema* ; Postoperative Complications ; Retinal Detachment ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Retrospective Studies ; Triamcinolone Acetonide ; Triamcinolone* ; Visual Acuity ; Vitreous Hemorrhage

No abstract available.
Humans ; Laser Therapy/methods ; Magnetic Resonance Imaging ; Male ; Orbital Cellulitis/*complications/diagnosis ; Retinal Vein Occlusion/diagnosis/*etiology/surgery ; Tomography, X-Ray Computed ; Young Adult