The activities of tissue- type plasminogen activator (t-PA) and plasminogen activator inhibitor(PAl) in plasm from 61 patients with retinal vein occlusion (RVO) were measured by using chromatogenous substrate s-2390 assay.The results showed that the t-PA activity in the patients with RVO were decreased (1.69plusmn;0. 56IU/ml, P＜0.01) and PAI activity increased (8.80plusmn;1.60AU/ml, P＜0. 01) comparing with health subjects 2.07plusmn;0.40IU/ml and 7.33plusmn;0.67AU/ml respectively. Among the patients, t-PA activity in the patients with ischemic retinopathy was more obviously decreased (1.35plusmn;0.43IU/ml, P＜0.01) and the activity of PAI was increased (9.35plusmn;1.37AU/mi) comparing with those patients suffering from nonischemic retinopathy (the activities of t-PA and PAI were 1.92 + 0.53IU/ml and 8.42plusmn;1.29AU/ml respectively, Plt;0.01). In addition, these changes were getting more obvious with the degree of severity of the disease. These results indicated that there was disorder in the balance between t-PA and PAI in patients with RVO,which my play an important role in the course of occurrence and development of RVO, especially in ischemic type. （Chin J Ocul Fundus Dis,1994,10:71-73）
Retinal vein occlusion (RVO) is one of the most common retinal vascular diseases causing blindness, macular edema (ME) is often secondary to it, which causes serious visual impairment to patients. Imaging biomarkers in the changes of retina and choroid of ME secondary to RVO (RVO-ME) have important clinical value in the evaluation of condition, curative effect and visual acuity prediction of patients with RVO-ME. Among them, the disorganization of the retinal inner layers, the integrity of external limiting membrane and ellipsoid zone, and the change of central macular thickness are reliable indexes to evaluate the prognosis of visual acuity; hyperreflective foci, subretinal fluid and intraretinal fluid can be used as important parameters to reflect the level of inflammation; prominent middle limiting membrane and paracentral acute middle maculopathy are the objective basis for judging the degree of retinal ischemia; the changes of choroidal vascular index and choroidal thickness also have potential advantages in evaluating the progress of the disease. Accurately grasp the characteristics of biological markers of RVO-ME related optical coherence tomography is conducive to its reasonable and accurate use in the clinical diagnosis and treatment of RVO-ME, and helpful to further explore the pathogenesis of the disease.
ObjectiveTo establish and preliminarily validate a nomogram model for predicting the risk of retinal vein occlusion (RVO). MethodsA retrospective clinical study. A total of 162 patients with RVO (RVO group) diagnosed by ophthalmology examination in The Second Affiliated Hospital of Xi'an Jiaotong University from January 2017 to April 2022 and 162 patients with age-related cataract (nRVO group) were selected as the modeling set. A total of 45 patients with branch RVO, 45 patients with central RVO and 45 patients with age-related cataract admitted to Xi 'an Fourth Hospital from January 2022 to February 2023 were used as the validation set. There was no significant difference in gender composition ratio (χ2=2.433) and age (Z=1.006) between RVO group and nRVO group (P=0.120, 0.320). Age, gender, blood routine (white blood cell count, hemoglobin concentration, platelet count, neutrophil count, monocyte count, lymphocyte count, erythrocyte volume, mean platelet volume, platelet volume distribution width), and four items of thrombin (prothrombin time, activated partial thrombin time, fibrinogen, and thrombin time) were collected in detail ), uric acid, blood lipids (total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, lipoprotein a), hypertension, diabetes mellitus, coronary heart disease, and cerebral infarction. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were calculated. The single logistic regression was used to analyze the clinical parameters of the two groups of patients in the modeling set, and the stepwise regression method was used to screen the variables, and the column graph for predicting the risk of RVO was constructed. The Bootstrap method was used to repeated sample 1 000 times for internal and external verification. The H-L goodness-of-fit test and receiver operating characteristic (ROC) curve were used to evaluate the calibration and discrimination of the nomogram model. ResultsAfter univariate logistic regression and stepwise regression analysis, high density lipoprotein, neutrophil count and hypertension were included in the final prediction model to construct the nomogram. The χ2 values of the H-L goodness-of-fit test of the modeling set and the validation set were 0.711 and 4.230, respectively, and the P values were 0.701 and 0.121, respectively, indicating that the nomogram model had good prediction accuracy. The area under the ROC curve of the nomogram model for predicting the occurrence of post-stroke depression in the modeling set and the verification set was 0.741 [95% confidence interval (CI) 0.688-0.795] and 0.741 (95%CI 0.646-0.836), suggesting that the nomogram model had a good discrimination. ConclusionsLow high density lipoprotein level, high neutrophil count and hypertension are independent risk factors for RVO. The nomogram model established based on the above risk factors can effectively assess and quantify the risk of post-stroke depression in patients with cerebral infarction.
Retinal vein occlusion (RVO) is a closely related disease of ophthalmology and systemic diseases. The Expert consensus on clinical diagnosis and treatment path of retinal vein occlusion in China (consensus) emphasizes that etiological diagnosis and treatment should be paid primary attention to, and etiological exploration should be placed in an important position in the diagnosis and treatment path. In addition to etiological treatment, the consensus emphasizes that clinical attention should be paid to the management of anterior segment neovascularization, neovascular glaucoma and macular edema. Especially for patients with short course of central retinal vein occlusion, the occurrence of 100-day glaucoma should be vigilant, and active anti-vascular endothelial growth factor (VEGF) drugs, laser photocoagulation and intraocular pressure treatment should be taken. For the treatment of macular edema, the consensus points out that anti-VEGF drugs and intraocular glucocorticoid sustained-release agents are effective, but the latter should be used cautiously to avoid problems such as high intraocular pressure glaucoma and accelerated cataract formation. For deficient RVO, the consensus defines its concept, defines the time point of treatment when combined with macular edema, and clarifies the applicable conditions of laser therapy.
Full thickness macular hole (FTMH) is a rare complication of retinal vein occlusion (RVO). These have different characteristics, and may associate with complications of RVO, such as cystoid macular edema and epiretinal membrane, and treatments like intravitreal injection. Although anatomical closure is often obtained with vitrectomy and inner limiting membrane peeling, visual improvement is often variable. Regularly follow-up, medical examination, and vitrectomy can improve the outcomes of patients. In the future, randomized controlled clinical trials with larger sample size are still needed to further explore the pathogenesis, clinical characteristics and treatment methods of FTMH after RVO, so as to improve the clinical prognosis of these patients.
Retinal vein occlusion (RVO) is one of the most important retinal vascular diseases in China that leads to severe loss of vision. In recent years, the emergence of various emerging imaging technologies and new drugs has not only deepened our understanding of the natural course of this disease, but also significantly changed the traditional treatment mode of retinal laser photocoagulation as the gold standard, thereby significantly improved the visual prognosis. However, currently in various regions and levels of hospitals in China, the diagnosis and treatment of RVO still rely mainly on their own experience. The awareness and knowledge of RVO among ophthalmologists in various regions still need to be improved. A standardized clinical diagnosis and treatment pathway is needed in order to meet the needs of most RVO patients. Led by the Fundus Disease Group of the Ophthalmology Branch of the Chinese Medical Association and the Fundus Disease Professional Committee of the Ophthalmology Branch of the Chinese Medical Association, based on the existing evidence-based evidence at home and abroad, and following the principles of consensus formulation, Expert consensus on clinical diagnosis and treatment path of retinal vein occlusion in China has been compiled. The consensus systematically and comprehensively elaborated a standardized diagnosis and treatment pathway for RVO. Interpreting the key points in this consensus is helpful to highlight the core ideas, and improve the utilization of this consensus by ophthalmologists from all levels of hospitals.
ObjectiveTo analyze the causal relationship between SARS-CoV-2 infection and retinal vascular obstruction by mendelian randomization (MR). MethodsA two-sample MR analysis utilizing summary statistics from genome-wide association studies (GWAS) in European populations was conducted. The GWAS data for SARS-CoV-2 infection comprised cases of common infection (2 597 856), hospitalized infection (2 095 324), and severe infection (1 086 211). Data on retinal vascular obstruction were obtained from the FinnGen database, which included 203 269 cases of retinal artery obstruction and 182 945 cases of retinal vein obstruction (RVO). Inverse variance weighting (IVW), random effects models, weighted median (WM), MR-Egger regression, simple models, and weighted models were used to analyze the bidirectional causal relationship between different SARS-CoV-2 infection phenotypes and retinal obstruction. The Q statistic was used to assess heterogeneity among single nucleotide polymorphisms (SNP), while MR-Presso was utilized to detect SNP outliers, and MR-Egger intercept tests were performed to evaluate horizontal pleiotropy. ResultsThe MR analysis, using IVW, random effects models, MR-Egger, WM, and weighted models, indicated no significant association between common SARS-CoV-2 infection, hospitalized infection, severe infection, and retinal vascular obstruction (P＞0.05). Additionally, retinal vascular obstruction did not show a significant association with the various SARS-CoV-2 infection phenotypes (P＞0.05). In the simple model, a significant association was found between severe SARS-CoV-2 infection and RVO (P＜0.05), as well as between RVO and common SARS-CoV-2 infection (P＜0.05). No heterogeneity was observed in the IVW and MR-Egger analyses (P＞0.05). The MR-Egger test provided no evidence of horizontal pleiotropy (P＞0.05), and MR-Presso detected no outlier SNP. ConclusionThe findings of this study do not support a causal relationship between SARS-CoV-2 infection and the occurrence of retinal vascular obstruction.
Objective To investigate the changes of ocular hemodynamics in patients with retinal vein occlussion(RVO)． Methods The hemodynamic parameters(PSV,EDV,PI,Vmax)of central retinal artery(CRA)and central retinal vein(CRV)were measured in the involved eyes(n=48) with RVO and the contralateral clinically healthy eyes(n=39) and in the control eyes(n=40) by color Doppler imaging (CDI)(ATLHDI3000). Results Peak systolic velocity (PSV) and end diastolic velocity (EDV) were significantly lower in the CRA of involved eyes and clinically healthy eyes of patients with RVO compared with control eyes,and pulsatility index(PI)was significantly higher in the CRA of involved eyes of patients with RVO compared with control eyes．PSV were significantly lower in the CRA of involved eyes of patients with RVO compared with their clinically healthy eyes．Pulsatility index(PI)was significantly higher in the CRA of involved eyes of patients with RVO compared with their clinically healthy eyes．Maximun vein velocity (Vmax) was significantly lower in the CRV of involved eyes and clinically healthy eyes of patients with RVO compared with control eyes． Conclusion The changes of hemodynamics in CRA,CRV of involved eyes of patients with RVO may invade their clinically healthy eyes．CDI may be helpful to early diagnosis for RVO． (Chin J Ocul Fundus Dis,1998,14:111-113)
Purpose To evaluate the efficacy of vitreous surgery and endolaser in a series of patients with retinal vein occlusion(RVO)with vitreous hemorrhage,neovascular membranes(NVM) and/or traction retinal detachment(TRD). Methods Clinical records were reviewed on 37 consecutive patients(38 eyes)who underwent vitreous surgery and endolaser for RVO with persistent vitreous hemorrhage,NVM and/or TRD.There were 19 patients(20 eyes)with retinal branch vein occlusion (BRVO)and 18 patients(18 eyes)with central retinal vein occlusion(CRVO). Results NVM and TRD were confirmed during operation in 27 and 23 eyes,respectively.Visual acuity improved postoperatively in 34 eyes(89.5%)including 22 eyes with 0.1 or better vision,and 4 eyes remained unchanged.CRVO group had longer history and less visual improvement after surgery. Conclusions Vitreous surgery and endolaser photocoagulation can improve the outcome in the majority of patients with RVO with vitreous hemorrage,NVM and/or TRD. (Chin J Ocul Fundus Dis,1998,14:3-6)