The Long-Term Effect of Cystotomy With Fibrinogen Clot Removal for a Cystoid Macular Edema Secondary to Idiopathic Macular Telangiectasia Type 1: A Case Report

Maki, Hitomi; Imai, Hisanori; Yamada, Hiroko; Tetsumoto, Akira; Hayashida, Miyeko; Otsuka, Keiko; Miki, Akiko; Nakamura, Makoto

doi:10.1097/icb.0000000000001117

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…2). Surgical complications include the damage to RPE or sensory retina, and retinal bleedings, however, improvement of visual acuity was reported in some eyes with persistent macular edema [31,32].…”

Section: Treatment Of Refractory and Prolonged Macular Edemamentioning

confidence: 99%

Retinal arterial and vein occlusion: is surgery ever indicated?

Kadonosono,

Inoue,

Yanagi

2024

Current Opinion in Ophthalmology

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Purpose of review To highlight the recent progression in surgical treatments for central retinal vein occlusion (CRVO) and central retinal artery occlusion (CRAO). Recent findings Anti-VEGF treatment, accepted as a primary treatment for CRVO, is unable to effectively treat all types of the diseases. Regarding CRAO, there are not any accepted therapies available. There have however been recent innovations in surgery, such as utilizing robotics-assisted tools in cannulation procedures for central retinal artery occlusion, or micro-cystotomy for refractory macular edema resulting from ischemic CRVO. Summary Refractory macular edema due to CRVO can be treated with aspiration of the fluid found inside the large cysts often seen in edema. The success rate of micro-cystotomy has been reported at 78% in eyes with refractory macular edema. Recent studies have shown that cannulation with tissue plasminogen activator (tPA) is effective for eyes with CRAO due to thrombus. Recent cannulation or micro-cystotomy procedures can be enhanced with the use of robotic tools which allow us to perform this difficult procedure more easily. Newly developed techn ology, and consequent developments in surgical procedures, will allow us to deal with unmet needs for retinal vessel occlusive diseases.

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Section: Treatment Of Refractory and Prolonged Macular Edemamentioning

confidence: 99%

Retinal arterial and vein occlusion: is surgery ever indicated?

Kadonosono,

Inoue,

Yanagi

2024

Current Opinion in Ophthalmology

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Cystotomy with or without fibrinogen clot removal for refractory cystoid macular edema secondary to branch retinal vein occlusion

Yamada

Imai

Tetsumoto

et al. 2021

Sci Rep

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To demonstrate the long-term effect of cystotomy with or without fibrinogen clot removal for treatment-resistant cystoid macular edema (CME) secondary to branch retinal vein occlusion (BRVO). Retrospective clinical study. We retrospectively analyzed medical records of 22 eyes of 22 patients with treatment-resistant CME secondary to BRVO with 12 months observation after cystotomy with or without fibrinogen clot removal. Patients included 11 women and 11 men. The mean ± SD age was 72.7 ± 10.2 years. LogMAR-converted best corrected visual acuity (BCVA) was statistically better at 12 months after surgery (0.30 ± 0.30) than preoperative BCVA (0.39 ± 0.27) (p = 0.01). The central sensitivity of microperimetry (dB) was maintained during follow-up (preoperative sensitivity: 25.4 ± 4.1, postoperative sensitivity at 12 months after the surgery: 25.9 ± 4.2, p = 0.69). Twelve months after surgery, there was a significant improvement in the central retinal thickness (CRT) on optical coherence tomography (OCT) (303.7 ± 80.1) (μm) compared with the preoperative CRT (524.2 ± 114.8) (p < 0.01). In 12 months, CME recurred in 3 of 22 eyes. The preoperative reflectivity in cystoid cavity on OCT was significantly higher in patients with fibrinogen clot removal (n = 5) than in patients without fibrinogen clot removal (n = 17) (p < 0.01). For treatment-resistant CME secondary to BRVO, Cystotomy with or without fibrinogen clot removal may be one of the treatment options.

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High Intraocular Concentration of Fibrinogen Regulates Retinal Function Via the ICAM-1 Pathway

Sotani,

Imai,

Yamada

et al. 2024

Invest. Ophthalmol. Vis. Sci.

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Purpose Diabetic retinopathy (DR) is a significant complication of diabetes mellitus that can lead to progressive visual impairment. This study aimed to elucidate the role of fibrinogen, a protein whose serum and intraocular concentrations are elevated in patients with diabetes and DR, in the pathogenesis of DR. Methods The changes in the protein levels of the neuronal marker tubulin-β3 (TUBB3) and retinal response induced by the intravitreal injections of 1× phosphate-buffered saline, 40 mg/mL of fibrinogen, and 40 mg/mL of fibrinogen in combination with anti–intracellular adhesion molecule-1 (ICAM-1) antibody in normal mice were observed using immunofluorescence, western blotting, and electroretinography. Results High concentrations of fibrinogen led to a decrease in the expression of TUBB3 in immunofluorescence and western blotting. The amplitudes of the positive scotopic threshold response and b-wave were notably reduced after the injection of fibrinogen, indicating potential damage to the retinal ganglion cells. The co-administration of anti–ICAM-1 antibody effectively mitigated these fibrinogen-induced changes, indicating that fibrinogen-induced damage is mediated via the ICAM-1 pathway. Conclusions The present study underscores the significance of elevated intraocular fibrinogen levels as a pathogenic factor in DR. Involvement of the fibrinogen/ICAM-1 pathway presents new avenues for therapeutic intervention, especially in patients with treatment-resistant conditions.

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The Long-Term Effect of Cystotomy With Fibrinogen Clot Removal for a Cystoid Macular Edema Secondary to Idiopathic Macular Telangiectasia Type 1: A Case Report

Cited by 3 publications

References 10 publications

Retinal arterial and vein occlusion: is surgery ever indicated?

Retinal arterial and vein occlusion: is surgery ever indicated?

Cystotomy with or without fibrinogen clot removal for refractory cystoid macular edema secondary to branch retinal vein occlusion

High Intraocular Concentration of Fibrinogen Regulates Retinal Function Via the ICAM-1 Pathway

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