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

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

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

PURPOSE: To investigate the incidence of neovascularization of the iris (NVI) and clinical features of patients with NVI following acute central retinal artery occlusion (CRAO). METHODS: A retrospective review of 214 consecutive CRAO patients who visited one tertiary hospital between January 2009 and January 2015 was conducted. In total, 110 patients were eligible for this study after excluding patients with arteritic CRAO, a lack of follow-up, iatrogenic CRAO secondary to cosmetic filler injection, or NVI detected before CRAO attack. Fluorescein angiography (FA) was applied until retinal arterial reperfusion was achieved, typically within 1 to 3 months. RESULTS: The incidence of NVI was 10.9% (12 out of 110 patients). Neovascular glaucoma was found in seven patients (6.4%). The mean time to NVI diagnosis after CRAO events was 3.0 months (range, 1 week to 15 months). The cumulative incidence was 5.5% at 3 months, 7.3% at 6 months, and 10.9% at 15 months. Severely narrowed ipsilateral carotid arteries were observed in only three patients (27.3%). The other nine patients (75.0%) showed no predisposing conditions for NVI, such as proliferative diabetic retinopathy or central retinal vein occlusion. Reperfusion rate and prevalence of diabetes were significantly different between patients with NVI and patients without NVI (reperfusion: 0% [NVI] vs. 94.7% [no NVI], p < 0.001; diabetes: 50.0% [NVI] vs. 17.3% [no NVI], p = 0.017). CONCLUSIONS: CRAO may lead to NVI and neovascular glaucoma caused by chronic retinal ischemia from reperfusion failure. Our results indicate that follow-up fluorescein angiography is important to evaluate retinal artery reperfusion after acute CRAO events, and that prophylactic treatment such as panretinal photocoagulation should be considered if retinal arterial perfusion is not recovered.
Carotid Arteries ; Diabetic Retinopathy ; Diagnosis ; Fluorescein Angiography ; Follow-Up Studies ; Glaucoma, Neovascular ; Humans ; Incidence* ; Iris* ; Ischemia ; Light Coagulation ; Perfusion ; Prevalence ; Reperfusion ; Retinal Artery Occlusion* ; Retinal Artery* ; Retinal Vein ; Retinaldehyde ; Retrospective Studies ; Tertiary Care Centers

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: The purpose of the study was to differentiate ischemic central retinal vein occlusion (CRVO) from nonischemic CRVO during the early acute phase using plasma homocysteine as a biochemical marker. METHODS: Fasting plasma homocysteine, serum vitamin B12, and folate levels were measured in 108 consecutive unilateral elderly adult (age >50 years) ischemic CRVO patients in the absence of local and systemic disease and compared with a total of 144 age and sex matched nonischemic CRVO patients and 120 age and sex matched healthy control subjects. RESULTS: Homocysteine level was significantly increased in the patients with ischemic CRVO in comparison with nonischemic CRVO patients (p = 0.009) and also in comparison with control subjects (p < 0.001). Analysis also showed that hyperhomocysteinemia was associated with increased incidence of ischemic CRVO (odds ratio, 18) than that for nonischemic CRVO (odds ratio, 4.5). Serum vitamin B12 and folate levels were significantly lower (p < 0.001) in CRVO patients compared to the control but were not significantly different between nonischemic and ischemic CRVO patients (p > 0.1). CONCLUSIONS: Hyperhomocysteinemia can be regarded as useful in differentiating nonischemic and ischemic CRVO during the early acute phase in absence of local and systemic disease in the elderly adult (age >50 years) population.
Acute Disease ; Aged ; Biomarkers/*blood ; Case-Control Studies ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Hyperhomocysteinemia/blood/*complications/diagnosis ; Male ; Middle Aged ; Prospective Studies ; Retinal Vein Occlusion/complications/*diagnosis ; Time Factors

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

A 58-year-old man admitted to our opthalmology department with the complaint of branch retinal vein occlusion. He was treated with intravitreal Ozurdex in the right eye. Two days after the injection, the patient presented with ocular pain and the visual acuity was hand movement. A diagnosis of endophthalmitis was made. We performed emergent pars plana vitrectomy (PPV) and the implant was removed from the vitreous cavity using a retinal forceps. A combination of vancomycin 1.0 mg and amikacin 0.4 mg was injected intravitreally. However, because of the blurring in the vitreus one week after the procedure, phacoemulsification and a repeat PPV was performed. Five days after the last procedure the signs and symptoms of endophthalmitis were resolved. Our case demonstrated that endophthalmitis could develop after intravitreal implantation of Ozurdex. Surgical removal of the implant and immediate vitrectomy seems to be a useful treatment option in these cases.
Device Removal/methods ; Dexamethasone/administration & dosage/*adverse effects ; Diagnosis, Differential ; Drug Implants/*adverse effects ; Endophthalmitis/diagnosis/*etiology/surgery ; Eye Infections, Bacterial/diagnosis/*etiology/surgery ; Glucocorticoids/administration & dosage/adverse effects ; Humans ; Intravitreal Injections/adverse effects ; Male ; Middle Aged ; Retinal Vein Occlusion/diagnosis/*drug therapy ; Vitrectomy

PURPOSE: To evaluate patients' self-recognition of reduced visual acuity due to recurring macular edema in retinal vein occlusion. METHODS: A retrospective review of medical records of patients who were diagnosed with recurring macular edema secondary to retinal vein occlusion was performed. The proportion of patients who recognized reduced visual acuity due to the recurrence of macular edema and who visited the hospital before the scheduled follow-up date was determined. Parameters including age, sex, diagnosis, visual acuity before recurrence of macular edema, and extent of visual acuity reduction due to recurrence of macular edema were compared in patients who recognized a reduction in visual acuity and those who did not. The proportion of patients who visited the hospital promptly was also determined. RESULTS: Forty eyes of 40 patients were included in the analysis. Sixteen and 24 patients were diagnosed with central retinal vein occlusion and branch retinal vein occlusion, respectively. Twenty-one patients (52.5%) recognized reduced visual acuity due to recurring macular edema. These patients were younger (59.2 +/- 7.6 vs. 64.8 +/- 9.4 years, p = 0.046), had better visual acuity before recurrence of macular edema (0.52 +/- 0.48 vs. 1.02 +/- 0.46, p = 0.002), and exhibited a greater reduction in visual acuity after recurrence of macular edema (0.34 +/- 0.24 vs. 0.14 +/- 0.13, p = 0.003). Only four patients visited the hospital before the scheduled follow-up date, and all of these patients lived relatively close to the hospital. CONCLUSIONS: For prompt treatment of recurring macular edema, more intensive education about the self-estimation of visual acuity is necessary, particularly for elderly patients who have relatively poor visual acuity. In addition, a simple and easy way to identify the recurrence of macular edema at the local clinic should be established for patients who live relatively far from the hospital.
Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Humans ; Macular Edema/*diagnosis/etiology/physiopathology ; Male ; Middle Aged ; *Patient Readmission ; Recurrence ; Retinal Vein Occlusion/*complications/diagnosis/physiopathology ; Retrospective Studies ; Tomography, Optical Coherence ; *Visual Acuity