Objective To evaluate the correlation between antiphospholipid (APLA) antibodies and retinal vein occlusion (RVO). Methods A computerized search was conducted in the Pubmed, Chinese Biological Medicine Database, China National Knowledge Infrastructure, VIP database, Wanfang Database combined with manually searching of literature reference proceedings. The search time was ranged from establishment of each database to August 1st, 2012. After the data extraction, quality of RCT was assessed. The meta analysis was performed by Stata 11.0. Results In total, 12 case-control studies (1324 subjects) that fulfilled the eligibility criteria were included in the meta-analysis involving 505 patients in RVO group and 819 subjects in control group. The odds ratio (OR) and 95% confidence interval (CI) of APLA, anticardiolipin antibodies (ACA), lupus coagulation inhibitor and RVO were 5.01 and 3.33 - 7.53,4.38 and 2.38 - 8.05, 1.72 and 0.73 - .88, 6.02 and 2.06 - 17.63, respectively. The OR and 95% CI of APLA, ACA, lupus coagulation inhibitor and branch RVO were 4.22 and 1.67 - 10.63, 3.69 and 1.32 - 10.32, 2.07 and 0.79 - 5.41, respectively. Conclusions APLA may increase the rick of RVO, especially ACA has a prediction function to RVO. It is necessary to screening for APLA in RVO patients.
Objective To observe the serum lipid level of patients with branch retinal vein occlusion (BRVO). Methods A total of 71 BRVO patients (BRVO group) were enrolled in this study. The patients included 31 males and 40 females, with an average age of (52.75plusmn;10.2) years. All the patients were examined for visual acuity, slit lamp ophthalmoscopy combine with preset lens, fundus color photography and fundus fluorescein angiography (FFA) examination. Seventy-two age and sex matched normal subjects were enrolled in this study as control group. The subjects included 32 males and 40 females, with an average age of (53.10plusmn;9.5) years. The BRVO and control group were divided into four subgroup which including age with ＜40 years, 40-49 years, 50-59 years and ge;60 years. The plasma cholesterol and triglyceride level of BRVO group, control group, and age subgroups of BRVO and control group were comparatively analyzed. Results The average plasma cholesterol levels were (4.529plusmn;0.100) and (4.274plusmn;0.106) mmol/L in BRVO and control group, respectively. There was no difference between two groups (t=-1.738，P＞0.05). The average triglyceride levels were (1.500plusmn;0.129) and (1.319plusmn;0.095) mmol/L in BRVO and control group, respectively. There was no difference between two groups (t=-1.135，P＞0.05). There was no difference of average plasma cholesterol (t=-1.755, 1.850, -1.892, -0.507) and triglyceride (t=0.846, -0.074, -1.288, -1.887) level in age subgroups of BRVO and control subgroup (P＞0.05). Conclusion There is no significant difference of serum lipid level between BRVO patients and controls.
Objective To observe the clinical features of combined central retinal artery and vein occlusion. Methods The clinical data of eight patients of combined central retinal artery and vein occlusion diagnosed by fundus examination and fundus fluorescein angiography (FFA) was analyzed retrospectively, including the causes, fundus manifestations and FFA features. Results 4/8 patients had hypertension and dyslipidemia, 2/8 patients had traumatic retrobulbar hemorrhage, one patient had orbital cellulitis and one patient had systemic lupus erythematosus. All the patients had posterior pole retinal edema, hemorrhage, thin retinal artery, dilated vein, and papilledema. FFA showed delayed arterial filling, and there was no filling of retinal arterial branches until the late stage of FFA. Laminar flow delayed in large retinal veins, and there was no filling or only retrograde filling in retinal vein branches. Large areas with dot-like or patchy weak choroidal fluorescence can be observed in five patients. Conclusions Combined central retinal artery and vein occlusion is rare with complex etiology. The fundus manifestations and FFA features are atypical, but have features of central retinal artery occlusion and central retinal vein occlusion.
Retinal vein occlusion (RVO) is affected by multiple factors, and there are lots of misunderstanding and disputation on the diagnosis and treatment. Compared with the natural disease course of RVO, there was no safe and effective treatment for RVO at present. Necessary investigation and disputation is helpful to make objective conclusion. We should objectively analyze and evaluate the results of investigation from home and abroad. (Chin J Ocul Fundus Dis, 2007, 23: 155-158)
Objective To observe the histopathological changes in human eyes with ischemic central retinal vein occlusion (CRVO), and to provide objective basis for effective methods of prevention and treatment for (CRVO). Methods Histopathological analysis was performed on the samples of 11 eyes in 11 patients with ischemic CRVO. The changes of central retinal veins (CRV) and central retinal arteries (CRA) wereobserved. Results The lumen of CRV became narrow when passed through the lamina cribrosa in 11 eyes, in which organized thrombus was found in the lamina cribrosa region and post lamina cribrosa region in 5 eyes, and organized thrombus re-unobstructed channels, endothelial proliferation and narrow lumen were found in 6 eyes. Arteriosclerosis of the CRA was observed in all of the 11 eyes with thick wall of the artery and narrow lumen. Proliferation of endothelium of wall of CRA and narrow lumen in the lamina cribrosa region was found in 2 eyes and no thrombus was found at the lamina cribrosa level. Conclusion During the course of ischemic CRVO, thrombus occurs in CRV at the level of lamina cribrosa. The prognosis of CRVO may lie on the time and degree the thrombosis re-opens. The mechanism of CRVO is that CRV is pressed in the narrow interspace of scleral channels of lamina cribrosa. (Chin J Ocul Fundus Dis, 2007, 23: 163-165)
Objective To investigate the clinical characteristic of ocular fundus complications in systemic lupus erythematosus (SLE). Methods In 25 cases of SLE with the ocular fundus complications, the ocular fundus, the other ocular tissues, general lesions，and antinuclear antibody (ANA ), anti-double-stranded DNA（anti-dsDNA）, complement 3 (C3), complement 4 (C4)and erythrocyte sedimentation rate(ESR) were analyzed retrospectively. Results In the 25 cases, “classic” SLE retinopathy in 15 (25 eyes), retinal vein occlusion (RVO) in 9 (12 eyes), RVO combined with retinal arter y occlusion in 1 (2 eyes), exudative retinal detachment in 1 (2 eyes), vitreous hemorrhage combined with neovascular glaucoma in 1 (1 eye), and optic discedem a except RVO in 3 (6 eyes) were found. Nine cases accompanied with other ocular signs and 21 with general lesions. Positive ANA and anti-dsDNA and elevated ESR in all of the patients, decreasing C3 in 19, and C4in 17 were found.Conclusions SLE can cause serious ocular fundus complications accompanied with other ocular signs. Regular ophthalmic examination should be performed on the patients with SLE to detect and treat the ocular complications promptly. (Chin J Ocul Fundus Dis，2004，20：206-208)
ObjectiveTo observe the differences of horizontal optic disc diameter and cup/disc (C/D) ratio in eyes with different kinds of retinal vein occlusion (RVO). MethodsA total of 392 eyes from 385 RVO patients diagnosed by fundus fluorescein angiography (FFA) were included in this study. The patients included 192 males and 193 females. The average age was (58.30±11.51) years. The disease duration was from 7 days to 1 month. The eyes were divided into RVO group (356 eyes), RVO combining diabetes mellitus (DM) group (20 eyes) and RVO combining high blood pressure (HP) group (16 eyes). One hundred normal eyes examined by FFA in the same testing period were selected as the control group. Among the 356 eyes in the RVO group, there were 201 eyes with branch RVO (BRVO), 100 eyes with central RVO (CRVO), 17 eyes with hemi CRVO (H-CRVO), and 38 eyes with macular BRVO (M-BRVO). Among the 101 non-ischemic RVO eyes, there were 17 eyes with BRVO, 53 eyes with CRVO, 6 eyes with H-CRVO, and 25 eyes with M-BRVO. Among the 255 ischemic RVO eyes, there were 184 eyes with BRVO, 47 eyes with CRVO, 11 eyes with H-CRVO and 13 eyes with M-BRVO. The diameter of optic cup and disk, and the C/D ratio was measured on fundus infrared radiation (IR) IR30°image by Heidelberg confocal laser fundus imaging system. ResultsThere was no significant difference of horizontal optic disc diameter among 4 groups (F=1.17, P>0.05). The difference of C/D ratio was significant among 4 groups (F=82.24, P<0.05). The differences of horizontal optic disc diameter and C/D ratio in different kinds of RVO in normal group and RVO group were significant (F=4.49, 61.396; P<0.05). The horizontal optic disc diameter of eyes with CRVO was a little smaller than normal eyes (P<0.05). There was no difference of horizontal optic disc diameter between the eyes with BRVO, M-BRVO, H-CRVO and normal eyes (P>0.05). The difference of C/D ratio was significant between the eyes with BRVO, CRVO, M-BRVO, H-CRVO and normal eyes (P<0.05). The differences of horizontal optic disc diameter and C/D ratio were significant between RVO group (in different kinds of RVO eyes) and control group (F=3.94, 33.16; P<0.05). Compared the horizontal optic disc diameters of RVO eyes with the same subtype, the difference was significant between non-ischemic H-CRVO and ischemic H-CRVO (P<0.05), while the differences were not significant between other non-ischemic RVO and ischemic CRVO (BRVO:P=0.35,CRVO:P=0.86,M-BRVO:P=0.22). The difference of C/D ratio between non-ischemic RVO and ischemic CRVO was not significant (BRVO:P=0.35,CRVO:P=0.48,H-CRVO:P=1.00,M-BRVO:P=1.00). ConclusionsThe C/D ratio increased with varying degrees in RVO eyes. There is no obvious change in horizontal optic disc diameters except for CRVO eyes.
ObjectiveTo observe serum homocysteine (Hcy) levels in retinal vein occlusion (RVO) patients with different ages and types. MethodsA total of 79 patients (79 eyes) diagnosed with RVO were enrolled. There were 33 females and 46 males, the mean age was (57.00±9.29) years. Eighty-two age-and sex-matched patients (82 eyes) without retinal vascular disease were included as controls. There were 32 females and 50 males, the mean age was (60.00±10.15) years. Among RVO patients, there were 24 patients younger than 50 years old (young patients) and 55 patients older than 50 years old (elderly patients); 35 patients with central RVO (CRVO) and 44 patients with branch RVO (BRVO). Fasting plasma Hcy, serum vitamin (Vit) B6, B12 and folate levels were measured in all patients. The relationship of high Hcy, low VitB6, low folate and RVO with different age were analyzed. ResultsHcy level was significantly higher in RVO patients than control subjects (t=2.946, P<0.01). Blood concentration of folate and VitB6 were significantly lower in RVO patients than control subjects (t=2.641, 2.889; P<0.01). Blood level of VitB12 was significantly different in RVO patients from control subjects (t=1.665, P>0.05). Concentrations of Hcy, folate, VitB12 and VitB6 were not different between patients with CRVO and BRVO (t=0.756,1.306,0.682,1.306;P>0.05). Hcy level was significantly higher in the young RVO patients than in the elderly RVO patients (t=2.394, P<0.05). Blood concentration of folate and VitB6 were lower in the young RVO patients than in the elderly RVO patients, but the difference were not significant(t=1.318, 1.694; P>0.05). The number of patients with high Hcy [χ2=13.67,odds ratio (OR)=3.327,95% confidence interval (CI)=1.742-6.354], low VitB6 (χ2=5.28,OR=2.068,95%CI=1.103-3.878) and low folate status (χ2=8.642,OR=2.546,95%CI=1.349-4.806) in RVO patients were more than control subjects (P=0.0001, 0.023, 0.004). ConclusionsHigh Hcy, low folate and low VitB6 were risk factors for the onset of RVO. Hcy may play more important role in young patients with RVO. Hcy, folate and VitB6 levels were similar in CRVO and BRVO patients.
Objective To observe the axial length and anterior chamber depth in eyes with branch retinal vein occlusion (BRVO). Methods Randomly selected 90 eyes of forty-five patients with BRVO were enrolled in this study. There were 25 males and 20 females. The mean age was (46.22±13.45) years. All the patients were underwent examination of visual acuity, slit-lamp microscope, indiophthalmoscope, fundus color photography and fundus fluorescence angiography (FFA). Randomly selected 45 healthy individuals for control group, including 28 males and 17 females. The mean age was (48.24±15.77) years. The axial lengths and anterior chamber depths of affected and fellow eyes of BRVO patients and the eyes of controls were measured using IOL Master. The data were compared by the two sample paired t test. Results The mean axial length of the affected eyes in the BRVO group was (22.69±0.99) mm, and that of the fellow eyes group was (22.78±1.24) mm. The difference in axial length between the affected eyes and fellow eyes in the BRVO group was not significant (t=0.355, P＞0.05). The mean axial length of the right eyes in the control group was (23.38±1.32) mm, and that of the left eyes in the control group was (23.37±1.27) mm. The difference in axial length between the left eyes and right eyes in the control group was not significant (t=0.017, P＞0.05), while the difference in axial length between the affected eyes in the BRVO group and the right, left eyes in the control group was significant (t=−2.563, −2.663; P＜0.05). The mean anterior chamber depth of the affected eyes in the BRVO group was (2.66±0.26) mm, and that of the fellow eyes was (2.65±0.30) mm. The difference in anterior chamber depth between the affected eyes and fellow eyes in the BRVO group was not significant (t=0.089, P＞0.05). The mean anterior chamber depth of the right eyes in the control group was (2.56±0.29) mm, and that of the left eyes was (2.59±0.30) mm. The difference in anterior chamber depth between the left eyes and right eyes in the control group was not significant (t=−0.592, P＞0.05). The difference in anterior chamber depth between the affected eyes in the BRVO group and the right, left eyes in the control group was not significant (t=1.779, 1.778, P＞0.05). Conclusion In the affected eyes of BRVO, the axial length is shorter and anterior chamber depth is normal.
Retinal vein occlusion (RVO) is the second visual threatening retinal disorders followed by diabetic retinopathy in the elderly. In the past decades, increasing knowledge of the natural history, aetiology and risk factors, medical management investigation, together with the support of high level evidence-based medical evidence and the results of real-world clinical trials play key roles in guiding the clinical practice. However, without understanding the pathogenesis and pathogeny of the disease, it is difficult to implement a comprehensive, precise and personalized treatment strategy for the RVO patients. It is of significance in the clinic to discuss the pathological process of RVO, analyze the etiological characteristics of the disease, reveal the clinical outcomes, which aim to facility the optimal treatment and follow-up procedure for the patients.