- •Retinal Vein Occlusions
- •Preface
- •Acknowledgments
- •Contents
- •1.1 Anatomy and Histology
- •1.2 Microanatomy of the Retina
- •1.3 Vascular Anatomy
- •Bernoulli’s Principle and Deductions Concerning Changes in Central Retinal Vein Diameter at the Lamina Cribrosa
- •1.4 Pathologic Anatomy
- •1.4.1 Abnormalities of the Vessel Wall
- •1.4.2 Branch Retinal Vein Occlusion
- •1.4.3 Central Retinal Vein Occlusion
- •1.4.4 Hemicentral Retinal Vein Occlusion
- •1.5 Summary of Key Points
- •References
- •2.1 Abnormalities of the Blood
- •2.1.1 Thrombosis
- •2.1.2 Viscosity of Blood
- •2.2 Abnormalities of Blood Flow
- •2.2.1 Retinal Vascular Hemodynamics
- •2.2.1.1 Laplace’s Law
- •2.2.1.2 Poiseuille’s Law
- •A Misapplication of Poiseuille’s Law
- •2.2.1.3 Hemodynamics of Central Retinal Vein Occlusion
- •How Severe Must Central Venous Obstruction Be to Produce Symptoms?
- •The Central Retinal Artery in Central Retinal Vein Occlusion
- •2.2.1.4 Hemodynamics of BRVO
- •2.3 Macular Edema
- •2.3.1 Macular Anatomy and Its Relationship to Macular Edema in Retinal Vein Occlusion
- •2.3.2 Starling’s Law
- •2.3.3 The Retinal Pigment Epithelial Pump
- •2.3.4 Molecular Signaling in Macular Edema
- •Relevant Molecular Biologic Terminology
- •2.3.4.1 Vascular Endothelial Growth Factor
- •2.3.4.2 Other Retinal Cytokines with Lesser Roles
- •2.3.4.3 Molecular Signaling in BRVO
- •2.3.4.4 Molecular Signaling in CRVO
- •What Does the Response of RVO to Intravitreal Anti-VEGF Drugs Say About Pathophysiology?
- •2.4 Retinal Neovascularization
- •Spontaneous Venous Pulsations and CRVO
- •2.7 Animal Models of Retinal Vein Occlusion
- •2.7.1 Animal Models of BRVO
- •2.7.2 Animal Models of CRVO
- •2.8 Summary of Key Points
- •2.9 Future Directions
- •References
- •3.1 Background for Clinical Genetics
- •3.2 The Role of Polymorphisms in Genetic Studies
- •3.3 Types of Genetic Study Design
- •Why Are So Many Association Studies for Retinal Vein Occlusion Negative?
- •3.4 Studies of the Genetics of Retinal Vein Occlusion
- •3.4.1 Platelet Glycoprotein Receptor Genes
- •3.4.2.1 Pooled Retinal Vein Occlusion
- •3.4.2.2 Central Retinal Vein Occlusion
- •3.4.2.3 Branch Retinal Vein Occlusion
- •3.4.4 202210G > A Mutation of the Prothrombin Gene (Factor II Leiden)
- •3.4.6 Protein C
- •3.4.7 Protein S
- •3.4.8 Fibrinogen
- •3.4.9 Factor XII
- •3.4.12 Other Negative Genetic Association Studies
- •3.5 Summary of Key Points
- •References
- •4.1 Nosology of Retinal Vein Occlusions
- •4.2 Branch Retinal Vein Occlusion
- •4.3 Central Retinal Vein Occlusion
- •Central Retinal Vein Occlusion with Nonischemic and Ischemic Hemispheres
- •4.3.1 Conversion from Nonischemic to Ischemic Forms of Retinal Vein Occlusion
- •4.4 Summary of Key Points
- •References
- •Quantifying Risk
- •The Major Epidemiologic Studies of Retinal Vein Occlusion
- •5.2 Prevalence
- •5.2.1 Pooled Retinal Vein Occlusion
- •5.2.2 Branch Retinal Vein Occlusion
- •5.2.3 Central Retinal Vein Occlusion
- •5.2.4 Hemicentral Retinal Vein Occlusion
- •5.3 Incidence
- •5.3.1 Pooled Retinal Vein Occlusion
- •5.3.2 Branch Retinal Vein Occlusion
- •5.3.3 Central Retinal Vein Occlusion
- •5.4 Risk and Protective Factors for Retinal Vein Occlusion
- •5.4.1.1 Pooled Retinal Vein Occlusion
- •5.4.1.2 Branch Retinal Vein Occlusion
- •5.4.1.3 Central Retinal Vein Occlusion
- •5.4.1.4 Hemicentral Retinal Vein Occlusion
- •5.4.2 Gender
- •5.4.2.1 Pooled Retinal Vein Occlusion
- •5.4.2.2 Branch Retinal Vein Occlusion
- •5.4.2.3 CRVO
- •5.4.2.4 Hemicentral Retinal Vein Occlusions
- •5.4.3 Race
- •5.4.4 Laterality
- •5.4.5 Body Mass Index
- •5.4.6 Education
- •5.4.7 Physical Activity
- •5.4.8 Miscellaneous Factors Explored and Not Found Important
- •5.5.1 Pooled Retinal Vein Occlusion
- •5.5.2 Branch Retinal Vein Occlusion
- •5.5.3 Central Retinal Vein Occlusion
- •5.5.4 Hemicentral Retinal Vein Occlusion
- •5.6 Life Expectancy
- •5.7 Visual Impact of Retinal Vein Occlusions
- •5.8 Summary of Key Points
- •References
- •6.1 Introduction
- •6.2 Systemic Associations
- •6.2.1 Hypertension
- •6.2.1.1 Pooled Retinal Vein Occlusions
- •6.2.1.2 Branch Retinal Vein Occlusion
- •6.2.1.3 Central Retinal Vein Occlusion
- •6.2.2 Diabetes Mellitus
- •6.2.2.1 Pooled Retinal Vein Occlusion
- •6.2.2.2 Branch Retinal Vein Occlusion
- •6.2.2.3 Central Retinal Vein Occlusion
- •6.2.3 Hyperlipidemia
- •6.2.3.1 Pooled Retinal Vein Occlusions
- •6.2.3.2 Branch Retinal Vein Occlusion
- •6.2.3.3 Central Retinal Vein Occlusion
- •6.2.4 Cardiovascular Disease
- •6.2.4.1 Pooled Retinal Vein Occlusion
- •6.2.4.2 Branch Retinal Vein Occlusion
- •6.2.4.3 Central and Hemicentral Retinal Vein Occlusion
- •6.2.4.4 Stroke
- •6.2.4.5 Carotid Artery Disease and Peripheral Vascular Disease
- •6.2.5 Rheologic and Hematologic Abnormalities
- •6.2.6 Coagulation Abnormalities
- •6.2.6.1 Antiphospholipid Antibodies
- •6.2.6.2 Factor VII
- •6.2.6.3 Factor VIII
- •6.2.6.4 Lipoprotein a
- •6.2.6.5 Von Willebrand Factor
- •6.2.6.6 Other Coagulation Factors
- •6.2.7 Hyperhomocysteinemia
- •6.2.7.1 Pooled Retinal Vein Occlusion
- •6.2.7.2 Branch Retinal Vein Occlusion
- •6.2.7.3 Central and Hemicentral Retinal Vein Occlusion
- •6.2.8 Serum Folate
- •6.2.9 Serum B12
- •6.2.10 Smoking
- •6.2.11 Alcohol Consumption
- •6.2.14 No Underlying Vascular Risk Factor
- •6.3 Ocular Associations
- •6.3.1 Pooled Retinal Vein Occlusion
- •6.3.2 Branch Retinal Vein Occlusion
- •6.3.3 Central Retinal Vein Occlusion and Hemicentral Retinal Vein Occlusion
- •6.4 Practical Recommendations About the Systemic Workup of Patients with Retinal Vein Occlusion
- •History of the Standard Workup for Systemic Associations in Central Retinal Vein Occlusion
- •6.5 Retinal Vein Occlusion and Cardiovascular Disease Risk
- •6.6 Differences in Systemic Associations Between Ischemic and Nonischemic CRVOs
- •6.7 Summary of Key Points
- •References
- •7.1 Branch Retinal Vein Occlusion
- •7.1.1 Acute Phase
- •7.1.1.1 Symptoms
- •7.1.2 Clinical Signs
- •7.1.2.1 Visual Acuity
- •7.1.3 Chronic Phase
- •7.1.3.1 Clinical Signs
- •7.1.3.2 Visual Acuity
- •Why Does the Visual Outcome in Nonischemic, Macula-Involving Branch Retinal Vein Occlusions Usually Vary with the Size of the Involved Retina?
- •7.2 Central Retinal Vein Occlusion
- •7.2.1 Acute Phase
- •7.2.1.1 Symptoms
- •7.2.1.2 Clinical Signs
- •When Retinal Venous Congestion and Optic Disc Edema Are Not Central Retinal Vein Occlusion
- •What Is the Relationship of Central Retinal Artery Pressure and Cilioretinal Artery Pressure?
- •Retinal Whitening Does Not Equal Infarction
- •A Clinical Picture Predicted by a Hypothesis
- •7.2.1.3 Visual Acuity
- •7.2.2 Chronic Phase
- •Why Are Optic Disc Collaterals Associated with Worse Initial and Final Visual Acuity After CRVO?
- •7.2.2.1 Visual Acuity
- •7.3 Hemicentral Retinal Vein Occlusion
- •7.3.1 Clinical Signs
- •7.3.2 Visual Acuity
- •7.4 Summary of Key Points
- •References
- •Which Measure of Reproducibility Is Best?
- •8.1 Color Fundus Photography
- •8.2 Fluorescein Angiography
- •8.2.1 Branch Retinal Vein Occlusion
- •8.2.2 Central Retinal Vein Occlusion
- •8.3 Optical Coherence Tomography and the Retinal Thickness Analyzer
- •Methods of Analysis of OCT in RVO
- •8.4 Visual Field Testing
- •8.5 Electroretinography
- •Electroretinography Essentials for Retinal Vein Occlusions
- •8.5.1 Branch Retinal Vein Occlusion
- •8.5.2 Central Retinal Vein Occlusion
- •8.5.3 Hemicentral Retinal Vein Occlusion
- •8.6 Indocyanine Green Angiography
- •8.7 Color Doppler Ultrasonographic Imaging
- •8.8 Laser Doppler Flowmetry
- •8.9 Ophthalmodynamometry
- •8.10 Scanning Laser Doppler Flowmetry
- •8.11 Laser Interferometry to Measure Pulsatile Choroidal Blood Flow
- •8.12 Vitreous Fluorophotometry
- •8.13 Summary of Key Points
- •References
- •9.1 Terminology
- •9.2 Branch Retinal Vein Occlusion
- •9.3 Central Retinal Vein Occlusion
- •9.3.1 Clinical Characteristics
- •In the Face of Evidence that Fluorescein Angiography Is Poorly Predictive of Ischemia in Acute Central Retinal Vein Occlusion, Why Is It Widely Used?
- •9.3.2 Conversion from Nonischemic to Ischemic Central Retinal Vein Occlusion
- •9.3.3 Outcomes by Ischemic Status
- •9.4 Interaction of Ischemia with Effects of Treatments
- •9.4.1 Branch Retinal Vein Occlusion
- •9.4.2 Central Retinal Vein Occlusion
- •9.5 Summary of Key Points
- •References
- •10.1 Branch Retinal Vein Occlusion
- •10.2 Central Retinal Vein Occlusion
- •10.3 Hemicentral Retinal Vein Occlusion
- •10.4 Treatment of Posterior Segment Neovascularization in Retinal Vein Occlusion
- •10.5 Summary of Key Points
- •References
- •11.1 The Pathoanatomy and Pathophysiology of Iris and Angle Neovascularization
- •11.2 Clinical Picture of Anterior Segment Neovascularization
- •11.4 Anterior Segment Neovascularization in Branch Retinal Vein Occlusion
- •11.5 Anterior Segment Neovascularization in Central Retinal Vein Occlusion
- •The Problem of Undetected Anterior Segment Neovascularization After Central Retinal Vein Occlusion
- •Why Is Anterior Segment Neovascularization Less Common in Central Retinal Vein Occlusion Than in Central Retinal Artery Occlusion?
- •11.6 Anterior Segment Neovascularization in Hemicentral Retinal Vein Occlusion
- •11.7 Summary of Key Points
- •References
- •12.1 Branch Retinal Vein Occlusion with Macular Edema
- •12.2 Central Retinal Vein Occlusion with Macular Edema
- •12.3 Summary of Key Points
- •References
- •Visual Acuity Measurement in Treatment Studies
- •OCT Measurement of Macular Thickness in Treatment Studies
- •13.1 Medical Treatment of Retinal Vein Occlusion
- •13.1.1 Anticoagulation
- •13.1.2 Systemic Thrombolytic Therapy
- •13.1.3 Isovolumic Hemodilution
- •Recipe for Isovolumic Hemodilution
- •13.1.4 Plasmapheresis
- •13.2 Treatment of Previously Unsuspected Risk Factors for Retinal Vein Occlusion
- •13.3.1 Treatments for Macular Edema
- •Relative Corticosteroid Potencies
- •13.3.2 Treatments for Intraocular Neovascularization
- •13.4 Results of Clinical Studies of Treatments for Macular Edema Secondary to Retinal Vein Occlusions
- •13.4.1 Branch Retinal Vein Occlusion
- •13.4.1.1 Grid Laser
- •13.4.1.2 Subthreshold Grid Laser Treatment
- •13.4.1.3 Sector Panretinal Laser Photocoagulation
- •13.4.1.5 Posterior Subtenon’s Triamcinolone
- •13.4.1.6 Intravitreal Corticosteroids
- •13.4.1.7 Combination Treatments Involving Intravitreal Triamcinolone Injections
- •13.4.1.8 Arteriovenous Sheathotomy
- •13.4.1.9 Vitrectomy
- •13.4.1.10 Intravitreal Injection of Autologous Plasmin
- •13.4.2 Central Retinal Vein Occlusion
- •13.4.2.2 Combination Regimen: Bevacizumab, Panretinal Laser, and Grid Laser
- •13.4.2.3 Systemic Corticosteroids
- •13.4.2.4 Posterior Subtenon’s Triamcinolone Injection
- •13.4.2.5 Intravitreal Corticosteroids
- •13.4.2.6 Vitrectomy
- •13.5 Treatment of Intraocular Neovascularization
- •13.5.1 Sector Panretinal Laser Photocoagulation for Retinal and Disc Neovascularization After Branch Retinal Vein Occlusion
- •13.5.2 Vitrectomy for Intraocular Neovascularization with Vitreous Hemorrhage
- •13.5.3 Laser Panretinal Photocoagulation for Anterior Segment Neovascularization
- •13.6 Economic Considerations
- •13.7 Future Directions
- •13.8 Summary of Key Points
- •References
- •14.1 Pooled Retinal Vein Occlusions in the Young
- •14.2 Branch Retinal Vein Occlusion in Younger Patients
- •14.3 Central Retinal Vein Occlusion in Younger Patients
- •14.4 Workup in the Younger Patient with Retinal Vein Occlusion
- •14.5 Summary of Key Points
- •References
- •15.1 Failed and Unadopted Treatments for Branch Retinal Vein Occlusion
- •15.1.1 Sector Panretinal Laser Photocoagulation for Serous Retinal Detachment in Branch Retinal Vein Occlusion
- •15.1.2 Laser Chorioretinal Venous Anastomosis for Branch Retinal Vein Occlusion with Macular Edema
- •15.1.3 Intravenous Infusion of Tissue Plasminogen Activator
- •15.1.4 Intravitreal Injection of Tissue Plasminogen Activator
- •15.1.5 Macular Puncture for Branch Retinal Vein Occlusion with Macular Edema
- •15.2 Failed and Unadopted Treatments for Central Retinal Vein Occlusion
- •15.2.1 Grid Laser for Macular Edema in Central Retinal Vein Occlusion
- •15.2.2 Chorioretinal Venous Anastomosis for Nonischemic Central Retinal Vein Occlusion with Macular Edema
- •15.2.3 Radial Optic Neurotomy for Central Retinal Vein Occlusion
- •15.2.4 Retinal Endovascular Surgery with Intravenous Injection of Tissue Plasminogen Activator
- •15.2.5 Intravitreal Injection of Tissue Plasminogen Activator
- •15.2.6 Intravitreal Tissue Plasminogen Activator and Triamcinolone
- •15.2.7 Systemic Acetazolamide for Central Retinal Vein Occlusion with ME
- •15.2.8 Combined Central Retinal Vein Occlusion and Central Retinal Artery Occlusion
- •15.2.9 Optic Nerve Sheath Decompression
- •15.2.10 Section of the Posterior Scleral Ring
- •15.2.11 Infusion of High Molecular Weight Dextran
- •15.3 Failed and Unadopted Treatments for HCRVO
- •15.4 Summary of Key Points
- •References
- •16.1 Case 16.1: An Asymptomatic Central Retinal Vein Occlusion with Asymmetric Hemispheric Involvement
- •16.1.1 Discussion
- •16.2 Case 16.2: Chronic Macular Branch Vein Occlusion with Subtle Ophthalmoscopic Signs, More Obvious Fluorescein Angiographic Signs, and Macular Edema
- •16.2.1 Discussion
- •16.3 Case 16.3: Old Hemicentral Retinal Vein Occlusion with Late Vitreous Hemorrhage and Hyphema
- •16.3.1 Discussion
- •16.4 Case 16.4: Spontaneous Improvement of a Nonischemic Central Retinal Vein Occlusion
- •16.4.1 Discussion
- •16.5 Case 16.5: Conversion of a Nonischemic Hemicentral Retinal Vein Occlusion to an Ischemic One
- •16.5.1 Discussion
- •16.6 Case 16.6: Nonarteritic Ischemic Optic Neuropathy Following Branch Retinal Vein Occlusion
- •16.6.1 Discussion
- •16.7 Case 16.7: Differentiating Central Retinal Vein Occlusion from the Ischemic Ocular Syndrome
- •16.7.1 Discussion
- •16.8 Case 16.8: Late Development of Neovascularization Elsewhere After Ischemic Branch Retinal Vein Occlusion
- •16.8.1 Discussion
- •16.9 Case 16.9: Nonischemic Central Retinal Vein Occlusion with Secondary Branch Retinal Artery Occlusion
- •16.9.1 Discussion
- •16.10 Case 16.10: Nonischemic Central Retinal Vein Occlusion with Macular Edema or Asymmetric Diabetic Retinopathy with Diabetic Macular Edema?
- •16.10.1 Discussion
- •16.11 Summary of Key Points
- •References
- •Index
Index
A
Ancillary testing CDUI, 215–216
coefficient of repeatability, 196 color fundus photography, 197
electroretinography (see Electroretinography) fluorescein angiography (see Fluorescein
angiography) ICG, 214–215
laser Doppler flowmetry, 216–217 laser interferometry, 218 ophthalmodynamometry, 217
optical coherence tomography (see Optical coherence tomography)
reproducibility, 195–197 RTA, 210
scanning laser Doppler flowmetry, 217 sensitivity, 195
specificity, 195
visual field testing, 210–211 vitreous fluorophotometry, 218 2 x 2 table, 195, 196
Anterior segment neovascularization (ASNV) anterior synechia, 251
BRVO, 254
ciliary body detachment, 250 classification of, 253–256 CRVO
aqueous VEGF concentrations, 257 factor VII, 260
ischemic, 257 Kaplan–Meier plot, 257–258
nonischemic categorization, 259 NVG, 260
optic disc collateral vessels, 260 PRP, 260
RAPD, 259
slit lamp examination, 258–259 ectropion uvea, 251
HCRVO, 261
iris anatomy, 249, 250
laser panretinal photocoagulation, 319–320
NVA (see Neovascularization of the angle) NVI (see Neovascularization of the iris) pathophysiology, 251
retinal ischemia, 250 Schlemm’s canal, 249 VEGF concentration, 250
Anterior synechia, 251 Antiphospholipid syndrome, 137, 285
Arteriovenous sheathotomy (AVS), 289, 309–310
B
Bandello, F., 255
Basic fibroblast growth factor (bFGF), 56–59 Beaumont, P.E, 109
Bernoulli’s principle, 17–18 Binder, S., 351
Boyd, S., 140
Branch retinal vein occlusion (BRVO) acute phase
cotton wool spots, 161, 162 etiology of, 160 hemorrhages, 164 inferotemporal, 161 macular edema, 161, 162 nonischemic/ischemic, 164
serous retinal detachment, 165 subretinal fluid, 161, 164 symptoms, 160
visual acuity, 165 vs. age, 113–115 animal model, 65
anti-VEGF drugs, intravitreal injection bevacizumab, 298
futility of therapy, 302, 305 vs. GL, 306
IVBI, 300–301 IVPI, 301
OCT center point (CPT), 300 pegaptanib, 299 ranibizumab, 298–299 recurrence rate, 306
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Index |
Branch retinal vein occlusion (BRVO) (cont.) reinjections, 302, 304
retinal collaterals, 303 risks of, 306
rules guiding, 299
visual prognosis, 304–305 arteriolar vasoconstriction, 62–63 arteriovenous crossing, 22–23 arteriovenous sheathotomy, 309–310 ASNV, 254
autologous plasmin, 311 bilaterality, 119–120 chronic phase
collateral vessels, 165–166 fibrotic sheathing, 165 lipid exudates, 166, 168 macroaneurysms, 166 macular edema, 166
retinal neovascularization, 166–167 SRD, 166
subretinal scarring, 166, 169 visual acuity, 167, 168, 170–171 vitreous attachment, 167 vitreous hemorrhage, 166, 169
diabetes mellitus, 130–131 electroretinography (ERG), 213
failed and unadopted treatments (see Failed and unadopted treatments)
fluorescein angiography, 23, 24 gender, 116
grid laser (GL)
arterial crimping, 297 BVOS, 294 cost-effectiveness, 297–298 disadvantage of, 297 re-treatment criteria, 296
serous retinal detachment, 297 subretinal fluid, 297
time course, 296 hemodynamics, 45
3H-thymidine labeling, cat model, 63 hyperhomocysteinemia, 139 hyperlipidemia, 131
hypertension, 129 incidence, 111
intravitreal corticosteroids, 307–308 intravitreal intriamcinolone injections, 308–309 ischemia (see Ischemia)
macular microaneurysm, 360
paracentral scotoma, 360–362 MCBRVO, 97
ME (see Macular edema) MJBRVO classification, 97, 100 molecular signaling, 57–58 MTHFR C677T mutation, 81, 83
nonarteritic ischemic optic neuropathy, 367 ocular association, 144–146 pathophysiology, 22
prevalence, 111
PSNV, 241–243
PSTI, 306–307 recanalization, 23, 24
retina trypsin digestion, 23, 25
sector panretinal laser photocoagulation, 298 subthreshold grid laser treatment, 298 vitrectomy, 311
in younger patients, 336 Brown, G.C., 251
C
Cahill, M.T., 140 Campochiaro, P.A., 299
Central retinal vein occlusion (CRVO) acute phase
ASNV, 171, 174 cotton wool spots, 173
CRAI, 171, 173, 175, 176 nonischemic, 171, 173 OCT, 173
ophthalmoscopic fundus sign, 171, 172 perivenular retinal whitening, 171, 173 PIRW, 174–175
RAPD, 172
subhyaloid macular bleeding, 172 symptoms, 171
visual acuity, 176 age, 114–116 animal model, 65–66
anti-VEGF drugs, intravitreal injection aflibercept, 314–315 antiproliferative effect, 315 CRUISE, 312–313
dosing frequency, 315 IVBI, 314, 315 IVRIs, 313–314
ranibizumab, 313 asymptomatic
intraretinal hemorrhages, 359, 361 optic disc collateral vessels, 359, 362 thrombus, 359–360
bilaterality, 120 chronic phase
ASNV, 183 conversion rates, 177
foveal hyperpigmentation, 179–182 macular atrophic scarring, 183–185 macular retinal pigment epithelial atrophy,
179, 182 nonischemic, 177
retinochoroidal collateral veins, 179, 182–183 untreated mascular edema, 177, 179
visual acuity, 183, 185, 186 cilioretinal artery, 61 combination regimen, 316 diabetes mellitus, 131
disc edema, 103 electroretinography, 100, 101 ERG, 213–214
Index |
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failed and unadopted treatments (see Failed and unadopted treatments)
fluorescein angiography, 201 gender, 117
hemodynamics, 43–45 hemorrhage, 101 histopathologic evidence, 24–25 hyperhomocysteinemia, 139–140 hyperlipidemia, 131–132 hypertension, 129–130
hypothetical intravascular pressure, 61–62 incidence, 113
intravitreal corticosteroids, 316–318 ischemia (see Ischemia)
ischemic retinal whitening, 62, 63 lamina cribrosa, 24, 26
ME (see Macular edema) molecular signaling, 58 MTHFR C677T mutation, 81, 82 nonischemic
chorioretinal venous anastomosis, 365 diabetic macular edema, 372, 374–376 patient history, 364, 365
scotoma, 372 OCT, 208
ocular association, 146–148 open-angle glaucoma, 59 pathoanatomy, 23–24
perimacular retinal whitening, 62–64
posterior subtenon’s triamcinolone injection, 316 prevalence, 111
PSNV (see Posterior segment neovascularization) and SVP, 60
systemic corticosteroids, 316 thrombus, 24, 27
vein and sclerotic artery, 24, 26 venous engorgement, 103 vitrectomy, 318
Charles, S., 309
Chen, C.H., 301
Cilioretinal artery occlusion, 176
Color Doppler ultrasonographic imaging (CDUI), 215–216
Color fundus photography, 197 Costa, R.A., 299, 315
D
Di Crecchio, 140
E
Early Treatment Diabetic Retinopathy Study (ETDRS), 107
Ectropion uvea, 251 Electroretinography (ERG)
BRVO, 213 CRVO, 213–214 HCRVO, 214
Naka–Rushton function, 211
Elman, M.J., 286
Erythropoietin (EPO), 57
Eye Disease Case Control Study (EDCCS), 88, 113,
116–118, 129–131, 141, 148
F
Factor V Leiden mutation (FVLM), 73, 335 Fahraeus–Lindqvist effect, 38
Failed and unadopted treatments ASNV, 355
BRVO
LCRVA, 346
macular puncture, 347
sector panretinal laser photocoagulation, 346 TPA, 346
CRVO
chorioretinal venous anastomosis, 348–350 grid laser, 347–348
high molecular weight dextran, 354 intra-arterial urokinase infusion, 354 optic nerve sheath decompression, 354 posterior scleral ring selection, 354 REVS, 352–353
RON, 350–352
systemic acetazolamide, 354 HCRVO, 355
PSNV, 355 reasons for, 345
Figueroa, M.S., 301, 315 Fluorescein angiography (FA)
arteriovenous transit time, 198 BRVO
complete venous obstruction, 199–200 intraretinal hemorrhage, 200 superotemporal, 200, 201
capillary nonperfusion, 198–199 CRVO, 201
disease phase, 197 fluorescein leakage, 199 masked grading, 198 reproducibility, 198
Fong, A.C.O., 342
Foveal avascular zone (FAZ), 13, 14 Foveal hyperpigmentation, 179–182
G
Gao, W., 140 Garcia-Arumi, J., 351 Gass, J.D.M., 170 Genetics
atherosclerotic cardiovascular disease, 81 case-control format, 77–78
DNA, 74–75
FVLM, 73 haplotype, 78
human genome, genetic marker, 76, 78 Human Genome Project, 78
MTHFR C677T mutation, 81, 82
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Index |
Genetics (cont.) PCR, 78–80
platelet glycoprotein receptor gene mutation and RVO, 81, 82
polymorphism, 76 protein synthesis, 75–76
restriction fragment length polymorphism, 76, 77 RVO risk factor, 73
SNPs and STRs, 76 thrombophilia, 73 translation, 75
Glacet-Bernard, A., 185 Gold, D., 255
Gregori, N.Z., 299, 301, 315
Gutierrez, J.C.M., 299, 301
H
Hansen, L.L., 287 Hasselbach, H.C., 351 Hayreh, M.S., 179, 189
Hayreh, S.S., 96, 99, 101, 130, 134, 145, 164, 179, 183, 185, 189, 224, 228, 231–233, 258, 261
Hazard ratio, 109
Hemicentral retinal vein occlusion (HCRVO), 25, 27 age, 116
ASNV, 261 bilaterality, 120 clinical signs, 186–188 ERG, 214
failed and unadopted treatments, 355 gender, 117
hyphema, 364
nonischemic to ischemic conversion capillary perfusion, 366
patient history, 365, 366 SCORE BRVO study, 367
patient history, 362, 364 prevalence, 111
PSNV, 245–246 visual acuity, 188–189
vitreous hemorrhage, 364 Hoeh, A.E., 299, 315
Hsu, J., 299
Hyperlipidemia, 125, 335, 336 Hyphema, 251, 253, 364
I
Indocyanine green angiography (ICG), 214–215 Internal limiting membrane peeling (ILMP), 289, 309,
310, 318 Intraocular neovascularization
intravitreal injection, anti-VEGF drugs, 320 laser panretinal photocoagulation, 319–320
sector panretinal laser photocoagulation, 318–319 vitrectomy, 319
Intravitreal bevacizumab injection (IVBI), 300–301 Ischemia, 101–103
BRVO
atrophy, 224
conversion rate, 224–225 fluorescein angiography, 224–226 fluorescein leakage, 224, 226, 227 inconsistency, 224
macular ischemia, 224 treatment, 233
CRVO
conversion rates, 232–233 initial visual acuity, 228 nonischemic type, 231
ocular neovascularization, 225, 228 outcomes, 233
RAPD, 232 treatment, 234–236 visual acuity, 231
ocular neovascularization, 223 vascular endothelial growth factor, 223
Ischemic index, 96 Ischemic ocular syndrome
diagnosis, 368, 370
patient history, 367, 369–370 Isovolumic hemodilution, 286–288
J
Jaissle, J.B., 299, 305
Jensen, 170
Johnson, M.A., 213
K
Kawaji, T., 307
Kearns, T.P., 370
Kohner, E.M., 286
Kondo, M., 299
Kuo, J.Z.C., 342
L
Laatikainen, L., 179
Laplace’s Law, 40–41
Laser chorioretinal venous anastomosis (LCRVA), 346 Laser Doppler blood-flow metry (LDBFM), 216–217 Laser interferometry, 218
Lattanzio, R., 140
Little, H.L., 255
Low molecular weight heparin (LMWH), 285 Luckie, A.P., 287
M
Macular edema (ME), 166, 228 BRVO
argon laser grid photocoagulation, 269 BDES, 266
bevacizumab, 266 blood flow velocity, 266
Index |
383 |
intravitreal triamcinolone, 266 ranibizumab, 269
vitreous status, 266 CRVO
BDES, 269
collateral vessels development, 273 CVOS, 269
cystic spaces, 269, 270, 275 ischemia, 269, 275 nonischemic, 269
OCT, 269, 271–273 visual acuity, 270–271
cytotoxic, 265 definition, 265
failed and unadopted treatments anastomosis, 348
chorioretinal venous anastomosis, 349 choroidovitreal neovascularization, 349 LCRVA, 346
preretinal fibrosis, 349, 350 treatment
AVS, 289 corticosteroids, 291
intravitreal injection, anti-VEGF drugs, 289, 290 isovolumic hemodilution, 293
laser photocoagulation, 289, 291 plasmin, 293
retinal oxygenation, 289 TPA, 293 vasoconstriction, 291 vitrectomy, 289, 291, 292
vasogenic, 265
Macular retinal pigment epithelial atrophy, 179, 182 Magargal, L.E., 189
Martinez-Jardon, C.S., 351 Martin, S.C., 140
May, D.R., 179 McIntosh, R.L., 179 Michels, R.G., 170 Microperimetry, 210–211 Moghimi, S., 140 Molecular signaling
antiangiogenic factor, 54, 55 bFGF, 57
BRVO, 57–58 CRVO, 58 EPO, 57 ICAM-1, 57
IL-6 and IL-8, 56–57 PGF, 57
proangiogenic factor, 54, 55 TGFa and PEGF, 54 VEGF
angiogenesis 56 forms of, 54–55
hypoxia-inducible factor, 56 intraocular neovascularization, 56 source of, 55–56
vasopermeability signaling pathway, 56
Moore, F., 170
Murakami, T., 347
N
Naka-Rushton function, 211 Narayanasamy, A., 140 Neovascular glaucoma (NVG)
BRVO, 254 CRVO, 258, 260 HCRVO, 261 younger patients
CRVO, 337, 342 Neovascularization elsewhere (NVE)
BRVO, 241, 242
CRVO, 242, 244 HCRVO, 245
Neovascularization of the angle (NVA) classification of, 253, 256
grading systems, 253, 255 Neovascularization of the disc (NVD)
BRVO, 241–243
CRVO, 242, 244 HCRVO, 245
Neovascularization of the iris (NVI) angle involvement, 254, 256 CRVO, 260
dilated state, 252
grading systems, 253, 255
iris fluorescein angiograms, 252, 254 pupillary margin, 254, 256 undilated state, 252
Nonarteritic ischemic optic neuropathy, 367
O
Ocular hypertension treatment study (OHTS), 144 Odds ratio, 108–109
Ohnishi, Y., 255 Ophthalmodynamometry, 217 Opremcak, E.M., 350, 351
Optical coherence tomography (OCT), 173 analysis method, 209
artifacts, 203–208 CRVO, 173, 208
intravitreal injection, anti-VEGF drugs, 300 macular thickness, 203
ME, 269, 271–273
morphological characteristics, 203, 208 Osterloh, M.D., 309
P
Panretinal photocoagulation (PRP), 257, 260–261 Partial thromboplastin time (PTT), 37 Perivenular ischemic retinal whitening (PIRW),
174–175 Pinna, A., 140 Poiseuille’s Law, 41–43
384 |
Index |
Population attributable risk (PAR), 109 Posterior segment neovascularization (PSNV)
BRVO
BDES, 241
new vessels, 242, 243
posterior vitreous detachment, 242 VH, 242
vitreous status, 242 CRVO, 242–243
average time, 244
posterior vitreous detachment, 243 preretinal/vitreous hemorrhage, 244–245 vitreous status, 243, 244
HCRVO, 245–246
intravitreal injection, anti-VEGF, 246 ischemia, 246
scatter laser photocoagulation, 246
Posterior subtenon’s triamcinolone injection (PSTI), 306–307
Posterior vitreous detachment (PVD) BRVO, 242
CRVO, 260 plasmin, 293 Prager, F., 299, 305
Priglinger, S.G., 299, 301, 305, 315 Puche, N., 299
Q
Quinlan, P., 185
R
Radial optic neurotomy (RON) central retinal vein, 350 Doppler ultrasound, 351–352 macular thickness results, 351
multifocal electroretinogram (mfERG) b-wave amplitudes, 351
VA results, 351 Ranibizumab, 6 Recchia, F.M., 342
Relative afferent pupillary defect (RAPD), 171–173, 232 Relative risk, 109
Retinal endovascular surgery (REVS) endovascular thrombolysis, 353 goal of, 352
Retinal neovascularization, 166–167 Retinal thickness analyzer (RTA), 210 Retinal vein occlusions (RVO)
anatomical risk factor, 95 anatomy and histology
axial length, 1, 2 macula and fovea, 2, 3
retina, stratified cellular nature, 2–4 scleral outlet vs. CRVO, 1–2 spectral domain OCT image, 2, 4
antithrombin deficiency, 88–89 blood-retina barrier, 3, 4 blood viscosity, 37–38
BMES and BDES, 109 BMI, 117–118
BRVO (see Branch retinal vein occlusion) classification of, 95, 96
clinical picture, 159 clinic-based study, 109–110 cotton wool spot, 27
CRVO (see Central retinal vein occlusion) 807C/T polymorphism, 83–84
economic considerations, 320–321 education, 118
ELM, 3, 4 epidemiology, 107 etiology, 97
factor II Leiden, 81, 83
factor V Leiden mutation, 81, 83 factor XII, 88
fibrinogen, 87–88 follow-up interval, 280–281 ganglion cell axon, 4, 5 G6PD, 89
GPIIb/IIIa, 81–83
202210G, prothrombin gene, 86 HCRVO
age, 116 bilaterality, 120 gender, 117 prevalence, 111
Henle’s layer, 4, 5 hemodynamics, 66–67 hospital-based control study, 89 ILM, 6
incidence, 108
intraocular neovascularization (see Intraocular neovascularization)
intraretinal crossing, 28 intravitreal injection therapy, 282 ischemic classification, 96 ischemic index, 96
IS/OS junction, 3, 4 laterality, 117
life expectancy, 120 macular edema
macula center, 50 macular lipid star, 50 microaneurysm, 49
molecular signaling (see Molecular signaling) muller cells, 50
proangiogenic and antiangiogenic factor, 54, 55 RPE pumping mechanism, 51–52
salt and water egress, 49–50 Starling’s Law (see Starling’s Law)
vascular hyperpermeability vs. RPE pumping, 52–53
vasogenic edema, 53 water transport, 53
5,10-methylenetetra-hydrofolate reductase, 84 MTHFR C677T mutation, 81, 82
Muller cell, 5 multidimensional grid, 107
Index |
385 |
neovascularization, 59, 60 nerve fiber layer, 6
nonischemic and ischemic form conversion, 104 nonresponders, 282
occulsion site, classification, 97, 98
OCT measurement, macular thickness, 284 oxygen exchange and autoregulation
cynomolgus monkey, preretinal oxygen tension, 45, 46
endothelin-1, 47 grid laser, 47–48
HCRVO, cotton wool spot, 48 hyperviscosity syndrome, 42, 47
nitric oxide, autoregulatory mediator, 46, 47 prostaglandins, 47
retinal oxygen tension, 46
transretinal oxygen partial pressure profile, 45, 46 venous occlusion, 45–46
watershed zone, 48 PAI-1, 86
pathophysiologic process, 33 photons, 3, 4
physical activity, 118 pooled RVO
age, 113, 114 bilaterality, 118–120 gender, 116 incidence, 111 prevalence, 111, 112
pooling methods, 95
predisposing and precipitating factor, 1 prevalence, 108
primary outcome, 280 protein C, 86–87 protein S, 87
quantifying risk, 108–109 race, 117
randomized controlled clinical trial, 281 RAPC and FVLM, 84–85
recurrence, 282
retinal vascular luminal diameter, 27 risk and protective factor, 108 robust population-based study, 110 RPE, 3, 4
secondary outcome, 280 side effect, 282
success rate, 282 thrombosis
antiphospholipid antibody, 36–37 antithrombin, 36
clotting cascade, 35, 36
coagulation biochemical pathway, 33, 35 factor VII, 37
factor XII, 37 fibrinolysis, 33, 35
platelet-platelet adhesion, 34
procoagulant and anticoagulant factor, 33, 35 PTT, 37
selectin, 34, 36 thrombomodulin-thrombin complex, 36
thrombospondin, 34 TPA, 36
Virchow’s triad, 33 VWF, 33–34
treatment
anticoagulation, 284–285 hyperhomocysteinemia, 288 isovolumic hemodilution, 286–288 plasmapheresis, 288
systemic thrombolytic therapy, 286 unsuspected risk factors, 288–289
type of, 1, 223
uncontrolled case series, 279 vascular anatomy, 18, 19
ADPase stained retinal vessel, 11, 13 arterial blood supply, 7 arteriovenous crossing, 20
Bjerrum scotomata, 11 blood supply, optic disc, 11
branch retinal artery occlusion, 15, 16 capillary bed, primate retina, 11, 13 central retinal artery, 10
circle of Zinn–Haller, 7–9 CRA and CRV, 10
CRV, 15–16
eye, venous drainage, 18, 19 FAZ, 13, 14
glaucomatous optic atrophy, 16, 18 inferotemporal BRVO, 14–15 mid-phase fluorescein angiogram, 19–20 ophthalmic artery, 7, 8
optic disc, 9, 10 optic nerve, 8, 9
peripapillary structure, 7–9 posterior ciliary artery, 7–9 prelaminar optic nerve, 8, 9
retinal arteries and vein relation, 18–19 retinal capillary, 11–12
retinal vein, 15, 18
right globe, arterial supply, 7, 8 RPCs, 11, 12
RPE-produced VEGF, 14 thromboxane A2 and angiotensin II, 12 trypsin digest, retina, 11, 14
vascular hemodynamics BRVO hemodynamics, 45
connections and intravascular pressure, 39 CRVO hemodynamics, 43–45
IOP, 38
Laplace’s Law (see Laplace’s Law) ocular perfusion pressure, 38 Poiseuille’s Law (see Poiseuille’s Law)
retinal venous physiology and hemodynamics, 38–39
VATR, 281
vessel wall abnormalities arteriosclerotic hypertrophy, 21
homocysteine metabolic pathway, 21–22 Virchow’s triad, 20
and vision loss measures, 107
386 |
Index |
Retinal vein occlusions (RVO) (cont.) visual acuity measurement, 283–284 visual impact, 121
vitreous and retina relation, 6–7 young (see Younger patients) zonula occludens, 5, 6
Risard, S., 299 Roger, S., 112, 117 Roth, S.M., 251
Rubeosis iridis. See Neovascularization of the iris Russo, V., 299, 301
S
Sanborn, G.E., 189
Scanning laser Doppler flowmetry, 217 Scanning laser perimetry, 210
Schatz, H., 176, 342
Sector panretinal laser photocoagulation, 346 Serous retinal detachment (SRD), 165 Single-nucleotide polymorphisms (SNPs), 76 Spontaneous venous pulsations (SVP), 60 Starling’s law, 50–51
Static perimetry, 210
Subhyaloid macular bleeding, 172 Systemic and ocular association alcohol consumption, 141
BDES, 126–127 BRVO and CRVO, 127 cardiovascular disease
BRVO, 132–133
carotid artery disease and peripheral vascular disease, 133–134
CRVO, 133 pooled RVO, 132 risk, 150
stroke, 133
case-control study, 125, 126 coagulation abnormalities
antiphospholipid antibodies, 136–137 classification of, 136
coagulation factors, 138 factor VII, 137
factor VIII, 137 lipoprotein a, 137–138 von Willebrand factor, 138
diabetes mellitus BRVO, 130–131 CRVO, 131 pooled RVO, 130
drugs, RVO, 142 epidemiologic study, 125 hyperhomocysteinemia
BRVO, 139
CRVO and HCRVO, 139–140 methionine loading test, 139 nongenetic factors, 138–139
plasma homocysteine concentration, 138 pooled RVO, 139
time vs. plasma homocysteine, 139
hyperlipidemia, 125 BRVO, 131 CRVO, 131–132 pooled Rvo, 131
hypertension BRVO, 129 CRVO, 129–130
pooled retinal vein occlusion, 128–129 and RVO, 128
ischemic and nonischemic CRVOs, 150 miscellaneous systemic association, 142–143 multiple systemic risk factor, 127
ocular association BRVO, 144–146
CRVO and HCRVO, 146–148 cup-to-disc ratio, 144
OHTS, 144
POAG, 144 pooled RVO, 144
POAG, 151 referral bias, 125
retrospective study, 126
rheologic and hematologic abnormalities erythrocyte aggregation, 134 prevalence and incidence, 134, 136 RVO association, 134–136
RVO, patient management, 134 serum B12, 141
serum folate, 140–141 smoking, 141
standard systemic workup, 149–150 systemic lupus erythematosus, 142 vascular risk factor, 143
venous thrombosis, 149
T
Tauber, J., 255
Teich, S.A., 255
Tissue plasminogen activator (TPA), 36 intravenous infusion, 346 intravitreal injection, 346–347, 353 REVS, 352–353
triamcinolone, 353–354
V
Virchow’s triad, 20
Visual acuity (VA) per thinning ratio (VATR), 280 Visual field testing, 210–211
Vitreous fluorophotometry, 218 Vitreous hemorrhage (VH), 242
von Willebrand factor (VWF), 33–34
W
Walsh, J.B., 255
Warfarin, 284–286
Weiss, D.I., 255
Wolf, S., 287
Index |
387 |
Wolf-Schnurrbusch, E.K., 196
Wroblewski, J.J., 299
Wu, L., 299, 301, 315
Y
Yaghoubi, G.H., 140 Younger patients
BRVO, 336 CRVO
capillary perfusion, 337 cessation of smoking, 337
cilioretinal arteriolar insufficiency, 337–338, 340, 341
elevated homocysteine, 337
ethnicity and environmental factors, 336–337 FVLM, 337
inflammatory etiology, 337
initial and follow-up visual acuities, 338, 342 intraocular neovascularization, 339, 342 ischemic, 339, 342
nonischemic, visual prognosis, 339, 342 optic disc edema, 337
prevalence of, 336 VA, 337
pooled RVO FVLM, 335
hypertension, 335
oral contraceptives, 336 prognosis, 336
Z
Zambarakji, H.J., 351
Zimmerman, B., 189
