Injection of tissue plasminogen activator into a branch retinal vein in eyes with central retinal vein occlusion

Weiss, Jeffrey N.

doi:10.1016/s0161-6420(01)00875-2

Cited by 186 publications

(48 citation statements)

References 16 publications

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“…The unsatisfactory results with systemic and intravitreal injections [147] promoted investigations of alternative routes of t-PA administration directly to the affected retinal vein [147]. The surgical techniques included PPV with posterior hyaloid removal, followed by cannulation of a peripapillary retinal vein branch and injection of a bolus of 200 µg/ml t-PA toward the ONH.…”

Section: Surgical Approaches To Treating Rvomentioning

confidence: 99%

Management of Retinal Vein Occlusion – Consensus Document

et al. 2011

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Retinal vein occlusion (RVO) can have severe consequences for the people affected by the disease, including visual loss with costly social repercussions. Currently, there is no European consensus with regard to the management of RVO. Following a careful review of the medical literature as well as the data from several clinical trials, a collaborative group of retina specialists put forth practical recommendations based on the best available scientific evidence for the clinical approach to RVO. Taking into consideration the recent advances in diagnostic tools and management options, the present document aims to provide the European ophthalmologists with guidelines for clinical practice to the benefit of their patients.

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Section: Surgical Approaches To Treating Rvomentioning

confidence: 99%

Management of Retinal Vein Occlusion – Consensus Document

et al. 2011

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“…One option would be vitreous surgery with cannulation of tPA into the retinal vein, achieving an improvement in VA of 3 lines or more in 54% of the patients [20]. Some surgeons have also reported successful results with radial optic neurotomy (RON), but complications of the procedure have been reported.…”

Section: Treatmentmentioning

confidence: 99%

“…Macular grid photocoagulation is an effective treatment to improve vision, but only for BRVO macular edema [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30]. In CRVO, even if the treatment clearly reduces angiographic evidence of macular edema, macular grid photocoagulation results in no VA improvement [33].…”

Section: Treatmentmentioning

confidence: 99%

Retinal Vein Occlusion: Current Treatment

Lattanzio¹,

Gimeno

Parodi³

et al. 2010

Ophthalmologica

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Retinal vein occlusion (RVO) is a pathology noted for more than 150 years. Although a lot has been written on the matter, it is still a frequent condition with multifactorial etiopathogenesis with many unclear aspects. The RVO pathogenesis has varied systemic and local implications that make it difficult to elaborate treatment guidelines. The management of the patient with RVO is very complex and a multidisciplinary approach is required in order to identify and correct the associated risk factors. Laser therapy remains the gold standard in RVO, but only modest functional improvement has been shown in branch retinal occlusion forms. Multicenter studies of intravitreal drugs present them as an option to combine with laser. Anti-vascular endothelial growth factor, corticosteroids and sustained-release implants are the future weapons to stop disease progression and get a better visual outcome. Consequently, it is useful to clarify some aspects of the pathology that allow a better patient management.

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“…This can be up to 2 minutes or even longer [5]. Given the small puncturing force, fragility and small size of retinal veins, it is very challenging to identify venous puncture, quickly stop needle insertion and hold it fixed throughout the injection period.…”

Section: Methodsmentioning

confidence: 99%

“…The procedure involves the injection of clot-dissolving tissue plasminogen activator (t-PA) directly into the occluded vein [5], which is very demanding because of the small size and fragility of retinal veins—especially if the occlusion is at a branch retinal vein (typically Ø<200 μm) rather than the central vein [6]. …”

Section: Introductionmentioning

confidence: 99%

Robot-assisted retinal vein cannulation with force-based puncture detection: Micron vs. the steady-hand eye robot

Gonenc

Tran

Gehlbach

et al. 2016

2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)

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Retinal vein cannulation is a demanding procedure where therapeutic agents are injected into occluded retina veins. The feasibility of this treatment is limited due to challenges in identifying the moment of venous puncture, achieving cannulation and maintaining it throughout the drug delivery period. In this study, we integrate a force-sensing microneedle with two distinct robotic systems: the handheld micromanipulator Micron, and the cooperatively controlled Steady-Hand Eye Robot (SHER). The sensed tool-to-tissue interaction forces are used to detect venous puncture and extend the robots’ standard control schemes with a new position holding mode (PHM) that assists the operator hold the needle position fixed and maintain cannulation for a longer time with less trauma on the vasculature. We evaluate the resulting systems comparatively in a dry phantom, stretched vinyl membranes. Results have shown that modulating the admittance control gain of SHER alone is not a very effective solution for preventing the undesired tool motion after puncture. However, after using puncture detection and PHM the deviation from the puncture point is significantly reduced, by 65% with Micron, and by 95% with SHER representing a potential advantage over freehand for both.

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Injection of tissue plasminogen activator into a branch retinal vein in eyes with central retinal vein occlusion

Cited by 186 publications

References 16 publications

Management of Retinal Vein Occlusion – Consensus Document

Management of Retinal Vein Occlusion – Consensus Document

Retinal Vein Occlusion: Current Treatment

Robot-assisted retinal vein cannulation with force-based puncture detection: Micron vs. the steady-hand eye robot

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