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Retinal Ischaemia (retinal + ischaemia)
Selected AbstractsIncrease of vascular endothelial growth factor and interleukin-6 in the aqueous humour of patients with macular oedema and central retinal vein occlusionACTA OPHTHALMOLOGICA, Issue 6 2010Hidetaka Noma Acta Ophthalmol. 2010: 88: 646,651 Abstract. Purpose:, This study aimed to investigate whether vascular endothelial growth factor (VEGF) or interleukin-6 (IL-6) influence macular oedema in patients with central retinal vein occlusion (CRVO). Methods:, Sixteen consecutive patients with unilateral CRVO and macular oedema were studied, along with eight age- and sex-matched patients without ischaemic ocular disease. Retinal ischaemia was evaluated from capillary non-perfusion on fluorescein angiography. Macular oedema was examined by optical coherence tomography. Aqueous humour (AH) samples were obtained during combined pars plana vitrectomy and cataract surgery, and were examined by enzyme-linked immunosorbent assay. Results:, Aqueous levels of VEGF and IL-6 were significantly elevated in patients compared with controls (p = 0.0142 and p < 0.0001, respectively). Aqueous levels of both molecules were significantly higher in patients with ischaemia than in those without ischaemia (p = 0.0026 and p = 0.0487, respectively). Furthermore, AH levels of VEGF and IL-6 were correlated with the severity of macular oedema (, = 0.7265, p = 0.0049, , = 0.5324, and p = 0.0392, respectively). Conclusions:, Both VEGF and IL-6 were elevated in the AH of patients with macular oedema and ischaemic CRVO, suggesting that these molecules may be related to the increase in vascular permeability in such patients. [source] Bevacizumab as adjuvant for neovascular glaucomaACTA OPHTHALMOLOGICA, Issue 1 2010Julia Beutel Abstract. Purpose:, We aimed to evaluate the longterm effects of intraocular bevacizumab (Avastin®) injections as adjuvant treatment in patients with neovascular glaucoma. Methods:, Twenty eyes of 18 consecutive patients with secondary neovascular glaucoma caused by proliferative diabetic retinopathy (n = 7), ischaemic central retinal vein occlusion (n = 7), ischaemic ophthalmopathy (n = 2) and retinal ischaemia resulting from persistent detachment (n = 2) were treated with intraocular bevacizumab injections (1.25 mg/0.05 ml) in addition to other treatments. The main outcome measure was the change in degree of iris rubeosis. Secondary outcomes included intraocular pressure (IOP), best corrected visual acuity (BCVA) and numbers of additional interventions or antiglaucoma medications administered after injection. Results:, Mean (± standard deviation) follow-up was 67.7 ± 13.8 weeks (range 50,93 weeks). At the last follow-up, complete regression of rubeosis was detectable in five (20%) eyes, incomplete regression in seven (35%), stabilization in six (30%), and an increase in two (10%) eyes. Mean IOP was 26.0 ± 8.9 mmHg at baseline and significantly decreased to 14.75 ± 5.3 mmHg at the last follow-up visit (p = 0.000005). Mean baseline BCVA (logMAR [logarithm of the minimum angle of resolution] 1.43 ± 0.89) was stabilized during the follow-up period (logMAR 1.5 ± 0.98). Patients received an average of 2.75 injections. Additional treatments were laser photocoagulation in 13 (65%) eyes, cyclodestructive procedure in 14 (70%), cryopexy in six (30%), drainage procedures in two (10%), and vitrectomy in five (25%) eyes. Conclusions:, Bevacizumab may be beneficial as adjuvant treatment in neovascular glaucoma because of its anti-angiogenic properties and its ability to prevent establishment or progression of angular obstruction. The causative disease inducing the angiogenic process requires treatment in all cases. Antiglaucoma treatment is needed in cases of persistent elevated IOP. [source] Inner retinal ischaemia: current understanding and needs for further investigationsACTA OPHTHALMOLOGICA, Issue 4 2009Toke Bek Abstract. Inner retinal ischaemia is involved in the pathogenesis of major vision-threatening diseases such as retinal vein thrombosis, diabetic retinopathy and retinopathy of prematurity. However, the pathogenesis of inner retinal ischaemia has not been fully elucidated, which represents an impediment to the development and improvement of techniques to prevent and treat these diseases on a rational basis. This paper provides a comprehensive review of current knowledge of the pathophysiology of inner retinal ischaemia, including clinical, anatomical and physiological aspects of disease development. It is suggested that chronic inner retinal ischaemia caused by capillary occlusion may develop secondary to an increase in hydrostatic pressure in the vessels. Further knowledge of the pathophysiology of inner retinal ischaemia can be obtained by identifying the mechanisms that lead to increased hydrostatic pressure in the capillary bed and establishing the structural and functional basis for the different response patterns in the central and peripheral areas of the retina that develop secondary to this increased hydrostatic pressure. Further elucidation of these unknown response patterns requires both in vitro and in vivo studies of retinal vascular pathophysiology. It is conceivable that a more detailed knowledge of these response patterns may help in the design of new treatments for retinal ischaemia and its vision-threatening consequences. [source] Intravitreal bevacizumab (Avastin) as a treatment of the neovascular complications of laser-induced chorioretinal anastomosis for nonischaemic central retinal vein occlusionCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 5 2009Kenneth C S Fong FRCOphth Abstract Purpose:, To describe the use of intravitreal bevacizumab followed by sectorial retinal photocoagulation to treat the neovascular complications of laser-induced chorioretinal anastomosis (L-CRA) for nonischaemic central retinal vein occlusion (CRVO). Methods:, Prospective interventional case series of three patients with nonischaemic CRVO who were treated with L-CRA. Patients were followed up every 2 weeks after the laser treatment. If neovascularization occurred at the site of the anastomosis, intravitreal bevacizumab (1.25 mg) was injected followed by laser photocoagulation to areas of retinal ischaemia and the area of retina anterior to the L-CRA 1 week later. Fluorescein angiography was performed to confirm the presence of neovascularization. Best-corrected visual acuity measurements were performed at every visit. Results:, Three patients (one woman, two men) with a mean age of 76.3 years developed neovascularization at the L-CRA site and underwent treatment as described with a mean follow-up time of 7 months. The neovascularization developed within 1 month after the laser anastomosis in all three cases. All patients only required one intravitreal bevacizumab injection to control the neovascularization. No complications of the intravitreal injections were noted. Conclusions:, Intravitreal bevacizumab appears to be an effective tool in the immediate control of neovascularization following L-CRA for nonischaemic CRVO. This appears to cause immediate regression of the neovascular frond and allows time for the laser, which is applied subsequently to have its effect. [source] Optic disc swelling in an adolescent with insulin dependent diabetes mellitusCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 6 2002Samantha Fraser-Bell BSc(Med) MBBS Abstract A 14-year-old Ukrainian girl with uncontrolled insulin dependent diabetes developed bilateral optic disc swelling when diabetic treatment was instituted. There was no retinal ischaemia. The disc swelling resolved completely over 8 months without specific ocular therapy. Disc swelling in juvenile diabetics must be differentiated from disc neovascularization. These patients may develop retinal ischaemia and neovascularization after the disc changes resolve. [source] | ||||||||||