PURPOSE: To evaluate the influence of retinal collateral vessels in eyes with macular edema secondary to branch retinal vein occlusion (BRVO) treated with intravitreal bevacizumab (IVB). METHODS: We reviewed the medical records of patients with BRVO who were followed up for 12 months. To compare formations of collateral vessels, the patients were divided into 2 groups. The treatment group included 20 patients (20 eyes) treated with IVB, and the control group included 41 patients (41 eyes) without treatment. RESULTS: In the treatment group, the mean age was 58.4 ± 9.5 years. The average number of IVB injections performed during the 12 months was 4.5 ± 2.5 (range 2 to 8). After 12 months from diagnosis, 13 eyes (65%) presented with collateral vessels. In the control group, the mean age was 60.6 ± 9.3 years and 28 eyes (68.3%) presented with collateral vessel after 12 months. There was no difference in incidence of collateral vessel formation between the treatment group and the control group (p = 0.574). CONCLUSIONS: IVB does not influence the formation of retinal collateralization in eyes treated for macular edema secondary to BRVO.
Diagnosis ; Humans ; Incidence ; Macular Edema ; Medical Records ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Bevacizumab

PURPOSE: To evaluate the influence of retinal collateral vessels in eyes with macular edema secondary to branch retinal vein occlusion (BRVO) treated with intravitreal bevacizumab (IVB). METHODS: We reviewed the medical records of patients with BRVO who were followed up for 12 months. To compare formations of collateral vessels, the patients were divided into 2 groups. The treatment group included 20 patients (20 eyes) treated with IVB, and the control group included 41 patients (41 eyes) without treatment. RESULTS: In the treatment group, the mean age was 58.4 ± 9.5 years. The average number of IVB injections performed during the 12 months was 4.5 ± 2.5 (range 2 to 8). After 12 months from diagnosis, 13 eyes (65%) presented with collateral vessels. In the control group, the mean age was 60.6 ± 9.3 years and 28 eyes (68.3%) presented with collateral vessel after 12 months. There was no difference in incidence of collateral vessel formation between the treatment group and the control group (p = 0.574). CONCLUSIONS: IVB does not influence the formation of retinal collateralization in eyes treated for macular edema secondary to BRVO.
Diagnosis ; Humans ; Incidence ; Macular Edema ; Medical Records ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Bevacizumab

PURPOSE: To identify the factors related to repeatability of intravitreal bevacizumab injections in patients with macular edema secondary to branch retinal vein occlusion (BRVO). METHODS: The present study included 26 patients with macular edema secondary to BRVO occurring within 1 month of diagnosis. Initial best corrected visual acuity, type of BRVO according to the involved vein branch, distance between fovea and occlusion vein, central macular thickness, type of macular edema, presence of macula hemorrhage, and presence of capillary nonperfusion were evaluated at the time of diagnosis. The patients received an intravitreal bevacizumab injection at the time of diagnosis and reinjections when macular edema and visual acuity were aggravated. According to the factors considered, the reinjection-free rate which was considered a survival rate was evaluated for 1 year after the first injection. RESULTS: The patients with initial visual acuity lower than log MAR 0.5 showed 52.6% survival rate within 1 year compared with 14.3% of the patients with visual acuity higher than log MAR 0.5 (p < 0.01). The patients with occluded vein closer than a distance of 2.5 disc diameters (DD) from the foveal center had a 57.1% survival rate and the patients with occluded vein farther than a distance of 2.5 DD from the foveal center had a 25.0% survival rate (p = 0.04). Macular BRVO and major BRVO patients had 64.3% and 16.7% survival rates, respectively (p = 0.01). CONCLUSIONS: The patients with BRVO may have less chance of repetitive intravitreal bevacizumab injections due to macular edema when initial visual acuity is lower than log MAR 0.5, occluded vein is closer than 2.5 DD from the foveal center, and macular branch is involved at the initial diagnosis. These factors can be utilized to predict the prognosis of BRVO patients and the probability of repetitive intravitreal bevacizumab injections.
Capillaries ; Diagnosis ; Edema* ; Hemorrhage ; Humans ; Macular Edema ; Prognosis ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Survival Rate ; Veins ; Visual Acuity ; Bevacizumab

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

PURPOSE: We analyzed and compared retinal ganglion cell damage between patients with glaucoma and those with branched retinal vein occlusion (BRVO). We performed two types of visual field examinations. METHODS: We retrospectively reviewed the medical records of 40 glaucoma eyes and 40 BRVO eyes. We compared the median deviation (MD), the pattern standard deviation (PSD), and sensitivity of damaged visual hemifield from frequency-doubling technology (FDT) C24-2 and standard automated perimetry (SAP) C24-2 visual field tests evaluation. We sought correlations between the MDs and retinal nerve fiber layer thickness as revealed by optical coherence tomography. RESULTS: MDs did not differ between the groups. PSD value was higher in glaucoma patients with FDT C24-2 test (p = 0.022), but no difference between two groups with SAP C24-2 test (p = 0.144). In terms of the sensitivity of the damaged visual hemifield, glaucoma patients had larger areas of damage in the FDT C24-2 test (p < 0.01). In regression analyses, the log R2 values of both tests were higher in glaucoma patients. CONCLUSIONS: Glaucoma patients had a greater damaged visual field area in the FDT C24-2 test than the SAP C24-2 test. The BRVO patients exhibited similar extents of damage in both tests. Thus, the subtypes and distributions of damaged retinal ganglion cells may differ between the conditions, facilitating differential diagnosis.
Diagnosis, Differential ; Glaucoma ; Humans ; Medical Records ; Nerve Fibers ; Retinal Ganglion Cells ; Retinal Vein Occlusion ; Retinal Vein ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Field Tests ; Visual Fields

Fourteen cases of central retinal vein occlusion (CRVO) were studied with electroretinogram (ERG) and fluorescein angiogram. The cases were divided into a venous stasis retinopathy group (VSR,9 cases) and a hemorrhagic retinopathy group(HR, 5 cases). The b/a ratio and retinal circualtion time (RCT) were measured and compared with the control group. The mean b/a ratio of the HR group (0.86) was decreased as compared with the VSR group (1.18) and the control group (1.23). The RCT of the HR group was markedly delayed to 13.68 seconds as compared with the VSR group (11.09 sec) and the control group (6.4 sec). These facts suggest that both the b/a ratio and the RCT are possible parameters for estimating retinal ischemia and that the ERG is a reliable examination method for classification of CRVO.
Adult ; *Electroretinography ; Female ; Fluorescein Angiography ; Humans ; Male ; Middle Aged ; Retinal Vein Occlusion/diagnosis/*physiopathology ; Retinal Vessels/*physiopathology ; Time Factors

PURPOSE: To report a rare case of thrombocytopenia after intravitreal bevacizumab injection (IVBI) in a patient with macular edema secondary to branch retinal vein occlusion (BRVO). CASE SUMMARY: A 52-year-old female presented to our clinic with complaints of visual disturbance in her right eye for 2 months. She was receiving hemodialysis therapy 3 times a week for 4 years due to chronic renal failure. Unilateral macular edema secondary to BRVO was observed on fundus examination and was confirmed with optical coherence tomography (OCT). The first IVBI was performed, and an additional injection was given 4 weeks later. Four weeks after the second injection, thrombocytopenia was present. The patient was followed up in our clinic without IVBI for 8 weeks and the platelet count recovered. Thrombocytopenia was reconfirmed after 2 additional monthly injections. After she revisited our clinic without IVBI for 8 weeks, the platelet count recovered without any treatment. CONCLUSIONS: When a patient presents with thrombocytopenia after IVBI with macular edema in BRVO, thrombocytopenia due to IVBI should be considered as a possible diagnosis.
Antibodies, Monoclonal, Humanized ; Diagnosis ; Female ; Humans ; Kidney Failure, Chronic ; Macular Edema* ; Middle Aged ; Platelet Count ; Renal Dialysis ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Thrombocytopenia* ; Tomography, Optical Coherence ; Bevacizumab

No abstract available.
Aged ; Diagnosis, Differential ; Female ; Fluorescein Angiography ; Fundus Oculi ; Humans ; *Intraocular Pressure ; Regional Blood Flow/*physiology ; Retina/*diagnostic imaging ; Retinal Hemorrhage/*diagnosis/physiopathology ; Retinal Vein Occlusion/*diagnosis

Experiments show that collaterals that develop and maturate in branch retinal vein occlusion (BRVO) are helpful in the drainage of blood from a blocked area to an adjacent area. Laser treatment on the nonperfusion area can reduce the retinal blood inflow that can impair the formation of collateral vessels. Furthermore, if collaterals were accidentally destroyed by laser photocoagulation, leakage and neovascularization would increase. Forty-five patients with BRVO were reviewed retrospectively. Collateral vessels were noted from angiographic analysis in 27 of 45 (60%) patients. Good visual prognosis was noted in the patients with collaterals. Cases with neovascularization underwent laser treatment. In one case, laser photocoagulation was applied to the collateral vessels accidentally, after which the leakage significantly increased on fluorescein angiography. In conclusion, collateral vessels in BRVO have a favorable effect on visual prognosis. Careful laser treatment is recommended to avoid destroying collaterals in BRVO.
Aged ; Aged, 80 and over ; Collateral Circulation ; Female ; Fluorescein Angiography ; Human ; Male ; Middle Aged ; Prognosis ; Retinal Neovascularization/diagnosis/*physiopathology ; Retinal Vein Occlusion/diagnosis/*physiopathology ; Retrospective Studies ; Visual Acuity

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