RECURRENT CENTRAL VENOUS RETINAL OCCLUSION, CLINICAL FEATURES AND TREATMENT OUTCOME
Abstract
Occlusion, thrombosis of the central retinal vein is the second most common vascular disease after diabetic retinopathy. Retinal vein occlusion usually affects the older population. Hypertension, stroke, advanced age, sex, hyperlipidemia are all significant risk factors. Anti-vascular endothelial growth factor agents have been shown to be effective in improving vision at this condition. Aim of this paper is to describe a 38-year-old woman with a medical history of hypertension who was complaining on blurred vision in the left eye. After a complete ophthalmological examination, she started with anti-VEGF treatment. After 3 monthly applications of aflibercept according to the T&E protocol, the treatment continued according to the PRN protocol, during which there was an exacerbation of the disease.
Keywords: central retinal vein occlusion, thrombosis, vascular, vascular endothelial growth factor, aflibercept.
References
2. Hayreh SS. Classification of central retinal vein occlusion. Ophthalmology 90(5), 458–474.
3. Hayreh SS, Zimmerman MB, Podhajsky P. Incidence of various types of retinal vein occlusion and their recurrence and demographic characteristics. Am J Ophthalmol. (1994) 117:429–41. doi: 10.1016/S0002-9394(14)70001-7
4. Rogers S, McIntosh RL, Cheung N et al. The prevalence of retinal vein occlusion: pooled data from population studies from the United States, Europe, Asia, and Australia. Ophthalmology 117(2), 313.e1–319.e1.
5. Parodi MB, Bandello F. Retinal vein occlusion: classification and treatment. Ophthalmologica 223(5), 298–305.
6. Pe’er J Folberg R Itin A Gnessin H Hemo I Keshet E. Vascular endothelial growth factor upregulation in human central retinal vein occlusion. Ophthalmology.
7. Noma H Funatsu H Mimura T Harino S Sone T Hori S. Increase of vascular endothelial growth factor and interleukin-6 in the aqueous humor of patients with macular oedema and central retinal vein occlusion. Acta Ophthalmol. 2010;
8. Choi EY, Kang HG, Lee SC, Kim M. Intravitreal dexamethasone implant for central retinal vein occlusion without macular edema. BMC Ophthalmol. (2019) 19:1–11. doi: 10.1186/s12886-019-1097-y
9. Posch-Pertl L, Weger M, Pinter-Hausberger S, List W, Posch F, Wedrich A, et al. Serum levels of antibodies against oxidation-specific epitopes are decreased in patients with retinal vein occlusion. Retina. (2021) 41:1193–201. doi: 10.1097/IAE.0000000000003001.
10. Avrutsky MI, Ortiz CC, Johnson KV, Potenski AM, Chen CW, Lawson JM, et al. Endothelial activation of caspase-9 promotes neurovascular injury in retinal vein occlusion. Nat Commun. (2020) 11:3173. doi: 10.1038/s41467-020-16902-5.
11. Hayreh SS. Ocular vascular occlusive disorders: natural history of visual outcome. Prog Retin Eye Res. (2014) 41:1–25. doi: 10.1016/j.preteyeres.2014.04.001.
12. Hayreh SS, Klugman MR, Beri M, Kimura AE, Podhajsky P. Differentiation of ischemic from non-ischemic central retinal vein occlusion during the early acute phase. Graefe’s Arch Clin Exp Ophthalmol. (1990) 228:201–17. doi: 10.1007/BF00920022.
13. Sen P, Gurudas S, Ramu J, et al. Predictors of visual outcoes following anti-VEGF treatment for macular edema secondary to central retinal vein occlusion. Ophthalmol Retina. 2021;
14. Shuchuko AG, Zlobin IV, Iureva TN, Ostanin AA, Chernykh ERR, Mikhalevich IM. Imtraocular cytokines in retinal vein occlusion and its relation to efficiency of anti-vascular endothelial growth factor therapy.Indian J Ophthalmology.1015;
15. Avrutsky MI, Ortiz CC, Johnson KV, Potenski AM, Chen CW, Lawson JM, et al. Endothelial activation of caspase-9 promotes neurovascular injury in retinal vein occlusion. Nat Commun. (2020) 11:3173. doi: 10.1038/s41467-020-16902-5.
16.Nicholson L, Vazquez-Alfageme C, Patrao NV, Triantafyllopolou I, Bainbridge JW, Hykin PG, et al. Retinal nonperfusion in the posterior pole is associated with increased risk of neovascularization in central retinal vein occlusion. Am J Ophthalmol. (2017) 182:118–25. doi: 10.1016/j.ajo.2017.07.015.
17. Sen P, Gurudas S, Ramu J,et al. Predictors of visual acuity outcomes following anti-VEGF treatment for macular edema secondary to central retinal vein occlusion. Ophthalmology Retina 2021;
18. Chakravarthy U, Havilio M, Syntosi A, et al. Impact of macular fluid volume fluctoations on visual acuity during anti-VEGF therapy in eyes with n-AMD.Eye (Lond.) 2021;
19. Evans RN, Reeves BC, Maguire MG, et al. Associations of variation in retinal thickness with visual acuity and anatomic outcomes in eyes with neovascular age-related macular degeneration lesions treated with anti-vascular endothelial growth factor agents. Jama Ophthalmologu 2020;