Increase of aqueous inflammatory factors in macular edema with branch retinal vein occlusion: a case control study

<p>Abstract</p> <p>Background</p> <p>This study investigated whether soluble intercellular adhesion molecule-1 (sICAM-1) has a role in the pathogenesis of macular edema associated with branch retinal vein occlusion (BRVO) together with vascular endothelial growth factor (VEGF).</p> <p>Methods</p> <p>A retrospective case control study was performed in 22 patients with BRVO and macular edema, as well as 10 patients with nonischemic ocular diseases as the control group. Retinal ischemia was evaluated by measuring the area of capillary non-perfusion with Scion Image software, while the severity of macular edema was examined by optical coherence tomography. Aqueous humor samples were obtained during the performance of combined vitrectomy and cataract surgery. sICAM-1 and VEGF levels in aqueous humor and plasma specimens were determined by enzyme-linked immunosorbent assay.</p> <p>Results</p> <p>Aqueous humor levels of sICAM-1 (median: 6.90 ng/ml) and VEGF (median: 169 pg/ml) were significantly elevated in BRVO patients compared with the control group (median: 3.30 pg/ml and 15.6 pg/ml, respectively) (<it>P </it>= 0.005 and <it>P </it>< 0.001, respectively). The aqueous humor level of sICAM-1 was significantly correlated with that of VEGF (<it>P </it>= 0.025). In addition, aqueous levels of both sICAM-1 and VEGF were correlated with the size of the non-perfused area of the retina in BRVO patients (<it>P </it>= 0.021 and <it>P </it>< 0.001, respectively). Furthermore, aqueous levels of sICAM-1 and VEGF were both correlated with the severity of macular edema (<it>P </it>= 0.020 and <it>P </it>= 0.005, respectively).</p> <p>Conclusions</p> <p>Both sICAM-1 and VEGF may be involved in the pathogenesis of macular edema associated with BRVO. Measurement of aqueous humor sICAM-1 levels may be useful for assessment of BRVO patients with macular edema, in addition to measurement of VEGF.</p

Vitreous inflammatory factors and serous retinal detachment in central retinal vein occlusion: a case control series

<p>Abstract</p> <p>Background</p> <p>This study investigated whether the vitreous fluid levels of soluble vascular endothelial growth factor receptor-2 (sVEGFR-2), pigment epithelium-derived factor (PEDF), and soluble intercellular adhesion molecule 1 (sICAM-1) were associated with the occurrence of serous retinal detachment (SRD) in patients with central retinal vein occlusion (CRVO).</p> <p>Methods</p> <p>We recruited 33 patients with CRVO and macular edema, as well as 18 controls with nonischemic ocular diseases. Eighteen of the 33 patients with CRVO showed SRD on optical coherence tomography of the macula (defined as subretinal accumulation of fluid with low reflectivity), while the other 15 patients only had cystoid macular edema (CME, defined as hyporeflective intraretinal cavities). Retinal ischemia was evaluated by measuring the area of capillary non-perfusion using fluorescein angiography and the public domain Scion Image program, while central macular thickness (CMT) was examined by optical coherence tomography. Vitreous fluid samples were obtained during pars plana vitrectomy and levels of the target molecules were measured by enzyme-linked immunosorbent assay.</p> <p>Results</p> <p>Ischemia was significantly more common in the SRD group (17/18 patients) than in the CME group (5/15 patients) (<it>P </it>< 0.001). The vitreous fluid level of sICAM-1 increased significantly across the three groups from the control group (4.98 ± 1.73 ng/ml) to the CME group (15.4 ± 10.1 ng/ml) and the SRD group (27.1 ± 17.7 ng/ml) (<it>p_trend</it>< 0.001). The vitreous fluid level of sVEGFR-2 also showed a significant increase across the three groups (1083 ± 541 pg/ml, 1181 ± 522 pg/ml, and 1535 ± 617 pg/ml, respectively, <it>p_trend</it>= 0.019). On the other hand, the vitreous fluid level of PEDF showed a significant decrease across the three groups (56.4 ± 40.0 ng/ml, 24.3 ± 17.3 ng/ml, and 16.4 ± 12.6 ng/ml, respectively, <it>p_trend</it>< 0.001).</p> <p>Conclusions</p> <p>Higher levels of inflammatory factors (sICAM-1 and sVEGFR-2) and lower levels of anti-inflammatory PEDF were observed in macular edema patients with SRD, suggesting that inflammation plays a key role in determining the severity of CRVO.</p

Influence of ischemia on visual function in patients with branch retinal vein occlusion and macular edema

Visual function and retinal morphology were investigated to elucidate the influence of ischemia in patients with branch retinal vein occlusion (BRVO) and macular edema. In 41 consecutive patients with BRVO aged 68.9 ± 10.0 years (22 women and 19 men), the area of capillary nonperfusion was measured by fluorescein angiography. Retinal thickness and retinal volume were measured by optical coherence tomography, and mean retinal sensitivity was calculated for each of 9 macular subfields. Mean visual acuity and macular sensitivity within the central subfield were not significantly correlated with the nonperfused area. However, the macular sensitivity within the central 5 subfields and all 9 subfields showed significant negative correlations with the nonperfused area. Also, macular thickness and volume within all 9 subfields were significantly correlated with the nonperfused area. In conclusion, evaluation of both the fovea and the entire macular region may be important in patients with ischemic BRVO

Comparison of the efficacy of intravitreal triamcinolone acetonide for cystoid macular edema with versus without serous retinal detachment in branch retinal vein occlusion: influence on macular sensitivity and morphology

Abstract Background The influence of serous retinal detachment (SRD) on visual acuity, macular sensitivity, and macular thickness is unclear after intravitreal injection of triamcinolone acetonide (IVTA) for macular edema with branch retinal vein occlusion (BRVO). Methods Twenty-one eyes of 21 BRVO patients with macular edema received IVTA. Patients were divided into two groups by optical coherence tomography findings: 11 patients who had cystoid macular edema (CME) with SRD (SRD (+) group) and 10 patients who had CME without SRD (SRD (−) group). Microperimetry was performed with a Micro Perimeter 1 before and at 3 and 6 months after IVTA. Macular thickness was measured by optical coherence tomography. We exchanged the superior and inferior regions to separate the regions into those with and without occlusion. As a result, the superior region was always the occluded region and the inferior region was non-occluded. Results In both the SRD (−) group and the SRD (+) group, the mean macular thickness within the central 4° field and the 10° and 20° fields of the occluded region decreased significantly from baseline to 3 and 6 months after IVTA (all P Conclusions These results suggest that IVTA may achieve more marked improvement of macular morphology in BRVO patients with SRD than in those without SRD, while this therapy may have a similar effect on macular function in BRVO patients with or without SRD.</p

Does Clear Cornea Cataract Surgery Influence Conjunctivochalasis?

This is a Letter to the Editor and does not have an abstract

Unusual orbital lymphoma undetectable by magnetic resonance imaging: a case report

<p>Abstract</p> <p>Introduction</p> <p>We report the case of a patient with orbital malignant lymphoma that was not detected by imaging studies when she presented with impaired vision, which lead to her eventual loss of sight.</p> <p>Case presentation</p> <p>A 71-year-old Japanese woman complained of deteriorating vision in her left eye. On examination, papilledema was detected, but magnetic resonance imaging only showed slight thickening and enhancement of the left optic nerve. A diagnosis of idiopathic optic neuritis was made and corticosteroid pulse therapy was administered. During the next four months, the patient received a total of four courses of corticosteroid pulse therapy, but she still suffered from bilateral loss of vision. A second magnetic resonance imaging procedure revealed tumors in both orbits and a biopsy showed diffuse large B-cell malignant lymphoma.</p> <p>Conclusion</p> <p>The possibility of malignant lymphoma should be considered in patients with recurrent optic neuropathy despite administration of corticosteroid pulse therapy, even when there are no abnormalities on cerebrospinal fluid examination or magnetic resonance imaging.</p

Visual function and serous retinal detachment in patients with branch retinal vein occlusion and macular edema: a case series

<p>Abstract</p> <p>Background</p> <p>The influence of serous retinal detachment (SRD) on retinal sensitivity in patients with branch retinal vein occlusion (BRVO) and macular edema remains unclear. This is despite the frequent co-existence of SRD and cystoid macular edema (CME) in BRVO patients on optical coherence tomography (OCT) and the fact that CME is the most common form of macular edema secondary to BRVO. We investigated visual function (visual acuity and macular sensitivity), macular thickness, and macular volume in patients with BRVO and macular edema.</p> <p>Methods</p> <p>Fifty-three consecutive BRVO patients (26 women and 27 men) were divided into two groups based on optical coherence tomography findings. Macular function was documented by microperimetry, while macular thickness and volume were measured by OCT.</p> <p>Results</p> <p>There were 15 patients with SRD and 38 patients with CME. Fourteen of the 15 patients with SRD also had CME. Visual acuity was significantly worse in the SRD group than in the CME group (P = 0.049). Also, macular thickness and macular volume within the central 4°, 10°, and 20° fields were significantly greater in the SRD group (P = 0.008, and P = 0.007, P < 0.001 and P < 0.001, and P < 0.001 and P < 0.001, respectively). However, macular sensitivity within the central 4°, 10°, and 20° fields was not significantly worse in the SRD group than in the CME group.</p> <p>Conclusions</p> <p>SRD itself may decrease visual acuity together with CME, because nearly all SRD patients also had CME. SRD does not seem to influence macular function on microperimetry.</p

Visual acuity and foveal thickness after vitrectomy for macular edema associated with branch retinal vein occlusion: a case series

Abstract Background The mechanism by which vitrectomy improves macular edema in patients with branch retinal vein occlusion remains unclear, although intraocular levels of vascular endothelial growth factor have been suggested to influence the visual prognosis and macular edema. Methods A series of 54 consecutive patients (54 eyes) with branch retinal vein occlusion was studied prospectively. All patients underwent pars plana vitrectomy for treatment of macular edema. Best corrected visual acuity and retinal thickness (examined by optical coherence tomography) were assessed before and after surgery. The level of vascular endothelial growth factor in vitreous fluid harvested at operation was determined. Patients were followed for at least 6 months postoperatively. Results Both the visual acuity and the retinal thickness showed significant improvement at 6 months postoperatively (P = 0.0002 and P Conclusions These results suggest that the vitreous level of vascular endothelial growth factor might influence the visual prognosis and the response of macular edema to vitrectomy in patients with branch retinal vein occlusion.</p