Peripheral retinal non-perfusion and treatment response in branch retinal vein occlusion

Aghdam, Kaveh Abri; Reznicek, Lukas; Sanjari, Mostafa Soltan; Framme, Carsten; Bajor, Anna; Klingenstein, Annemarie; Kernt, Marcus; Seidensticker, Florian

doi:10.18240/ijo.2016.06.12

Cited by 9 publications

(7 citation statements)

References 22 publications

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“…In another study of 33 patients with BRVO, baseline central subfield thickness was 564 µm among those with between 50 and 100 fields of peripheral retinal non-perfusion compared to 373 µm among those with 0–49 fields of non-perfusion [52].…”

Section: Impact Of Retinal Non-perfusion On Disease Manifestationsmentioning

confidence: 99%

“…The extent of retinal non-perfusion may correlate with the final visual acuity in RVO. In a study of 53 patients with BRVO, patients with greater retinal non-perfusion (50 to > 100 fields) had final best-corrected visual acuity (BCVA) of 34.76 ETDRS letters, whereas those with smaller areas of retinal non-perfusion had BCVA of 40.63 letters [52].…”

Section: Impact Of Retinal Non-perfusion On Treatment and Follow Upmentioning

confidence: 99%

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Wide-field angiography in retinal vein occlusions

Tan

Sadda

2019

Int J Retin Vitr

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BackgroundRetinal vein occlusion (RVO) is the second most common retinal vascular disease after diabetic retinopathy. It can result in significant visual loss from complications like macula edema, retinal and iris neovascularization, and vitreous hemorrhage. Recently, ultra-widefield imaging (UWF) has been developed for posterior pole visualization and has shown to be useful in the evaluation and treatment of RVO.Main textUltra-widefield imaging (UWF) imaging allows for visualization of the retina up to an angle of 200°. This is especially important in detecting peripheral retinal pathologies, especially in retinal conditions such as RVO, where the disease process affects the peripheral as well as central retina. In particular, retinal non-perfusion in RVO is a risk factor for neovascularization. Various techniques, such as ischemic index and stereographic projection, have been described to assess areas of ischemia on UWF images. Retinal non-perfusion has an impact on disease complications, such as macular edema, and retinal and iris neovascularization. Retinal non-perfusion also has implications on disease response, including visual acuity, reduction in retinal edema and treatment burden.ConclusionUltra-widefield imaging (UWF) imaging plays an important role in the assessment and management of RVO, especially in measuring retinal non-perfusion in the peripheries.

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Section: Impact Of Retinal Non-perfusion On Disease Manifestationsmentioning

confidence: 99%

Section: Impact Of Retinal Non-perfusion On Treatment and Follow Upmentioning

confidence: 99%

Wide-field angiography in retinal vein occlusions

Tan

Sadda

2019

Int J Retin Vitr

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“…The management of macular edema secondary to branch retinal vein occlusion has greatly improved in recent times with the introduction of a therapy based on intravitreal injection of antivascular endothelial growth factor (VEGF) molecules and steroids [69]. Patient outcomes even with identical treatments can be vastly different due to disease, and patient heterogeneity prognostic factors for BRVO include patient age [70], baseline visual acuity and retinal thickness [51, 71, 72], early response to treatment [70], duration of macular edema [73, 74], posterior vitreous detachment [75], OCT characteristic [76–78], cytokine level [34, 79], central retinal sensitivity [80], leaking capillaries and microaneurysms in the perifoveal capillary network [60, 81, 82], retinal pigment epithelium (RPE) integrity [83, 84], serious retinal detachment [85], and subretinal hemorrhage [86]. Some of these prognostic factors are still controversial.…”

Section: Treatmentmentioning

confidence: 99%

New Developments in the Classification, Pathogenesis, Risk Factors, Natural History, and Treatment of Branch Retinal Vein Occlusion

Paulus

Shuai

et al. 2017

Journal of Ophthalmology

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For years, branch retinal vein occlusion is still a controversial disease in many aspects. An increasing amount of data is available regarding classification, pathogenesis, risk factors, natural history, and therapy of branch retinal vein occlusion. Some of the conclusions may even change our impression of branch retinal vein occlusion. It will be beneficial for our doctors to get a deeper understanding of this disease and improve the treatment skills. The aims of this review is to collect the information above and report new ideas especially from the past a few years.

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“…We previously reported that peripheral retinal nonperfusion correlates significantly with intravitreal ranibizumab injections in patients with BRVO and macular edema. 33 Rehak et al 34 evaluated 22 CRVO patients in a randomized clinical trial and suggested the selective laser photocoagulation of peripheral areas of nonperfusion may further improve the visual outcome and decrease the number of needed ranibizumab reinjections in CRVO patients.…”

Section: Discussionmentioning

confidence: 99%

Anti-VEGF treatment and peripheral retinal nonperfusion in patients with central retinal vein occlusion

Aghdam¹,

Reznicek²,

Sanjari³

et al. 2017

OPTH

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PurposeTo evaluate the association between the size of peripheral retinal nonperfusion and the number of intravitreal ranibizumab injections in patients with treatment-naïve central retinal vein occlusion (CRVO).MethodsFifty-four patients with treatment-naïve CRVO and macular edema were included. Each patient underwent a full ophthalmologic examination including optical coherence tomography imaging and ultrawide-field fluorescein angiography. Monthly intravitreal ranibizumab injections were applied according to the recommendations of the German Ophthalmologic Society. Two ophthalmologists quantified the areas of peripheral retinal nonperfusion (group 1= less than five disc areas, group 2= more than five disc areas). Correlation analyses between the size of nonperfusion with best-corrected visual acuity, central subfield thickness, and the number of intravitreal injections were performed.ResultsBest-corrected visual acuity improved significantly after intravitreal injections (P<0.001, both groups). Final central subfield thickness after treatment did not significantly differ between both groups (P=0.92, P=0.96, respectively). Mean number of injections in group 1 and group 2 was 4.12±2.73 and 9.32±3.84, respectively (P<0.001). There was a significant positive correlation between areas of nonperfusion and the number of injections in each group. (R=0.97, P<0.001; R=0.94, P<0.001, respectively).ConclusionPeripheral retinal nonperfusion in patients with CRVO correlates significantly with the number of needed intravitreal ranibizumab injections. Ultrawide-field fluorescein angiography is a useful tool for detection of peripheral retinal ischemia, which may have direct implications in the diagnosis, follow-up, and treatment of these patients.

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Peripheral retinal non-perfusion and treatment response in branch retinal vein occlusion

Abstract: Peripheral retinal non-perfusion in patients with BRVO associates significantly with intravitreal ranibizumab injections in patients with BRVO and macular edema.

Cited by 9 publications

References 22 publications

Wide-field angiography in retinal vein occlusions

Wide-field angiography in retinal vein occlusions

New Developments in the Classification, Pathogenesis, Risk Factors, Natural History, and Treatment of Branch Retinal Vein Occlusion

Anti-VEGF treatment and peripheral retinal nonperfusion in patients with central retinal vein occlusion

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