Branch vein occlusion

分支静脉闭塞
  • 文章类型: Journal Article
    目的:使用超宽视野(UWF)眼底成像结合导航中央和周边横截面和三维(3D)扫频源光学相干断层扫描(SS-OCT)扫描评估中央和周边视网膜和脉络膜疾病。
    方法:回顾性研究,涉及332名连续患者,男性和女性的分布几乎相等。患者的平均年龄为52岁(范围18-92岁)。平均屈光误差为-3.80D(范围为7.75至-20.75D)。
    结果:本研究中的观察结果证明了外周导航SS-OCT在评估各种眼部疾病中的功效。该技术提供了高质量的周边玻璃体图像,玻璃体视网膜界面,视网膜,和脉络膜,使玻璃体漂浮物和混浊物可视化,视网膜裂孔和眼泪,色素性病变,和周边视网膜变性。3DOCT扫描增强了这些异常的可视化,并改善了诊断和治疗决策。
    结论:导航的中央和周边横断面和3DSS-OCT扫描在视网膜疾病的评估和管理中提供了显著的互补益处。他们除了UWF成像提供了中央和周边眼结构的全面视图,帮助早期发现,精确的解剖学测量,和疾病进展的客观监测。此外,这项技术是患者教育的宝贵工具,学员的教学工具,和用于医学法律目的的文件。
    OBJECTIVE: To assess central and peripheral retinal and choroidal diseases using ultra-widefield (UWF) fundus imaging in combination with navigated central and peripheral cross-sectional and three-dimensional (3D) swept source optical coherence tomography (SS-OCT) scans.
    METHODS: Retrospective study involving 332 consecutive patients, with a nearly equal distribution of males and females. The mean age of patients was 52 years (range 18-92 years). Average refractive error was -3.80 D (range +7.75 to -20.75 D).
    RESULTS: The observations in this study demonstrate the efficacy of peripheral navigated SS-OCT in assessing various ocular conditions. The technology provides high-quality images of the peripheral vitreous, vitreoretinal interface, retina, and choroid, enabling visualization of vitreous floaters and opacities, retinal holes and tears, pigmented lesions, and peripheral retinal degenerations. 3D OCT scans enhance the visualization of these abnormalities and improve diagnostic and therapeutic decisions.
    CONCLUSIONS: Navigated central and peripheral cross-sectional and 3D SS-OCT scans offer significant complementary benefits in the assessment and management of retinal diseases. Their addition to UWF imaging provides a comprehensive view of central and peripheral ocular structures, aiding in early detection, precise anatomical measurements, and objective monitoring of disease progression. In addition, this technology serves as a valuable tool for patient education, a teaching tool for trainees, and documentation for medico-legal purposes.
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  • 文章类型: Journal Article
    使用OCT监测玻璃体内治疗在临床实践中各不相同,并不总是强制性的。ALBATROS数据收集旨在阐明常规实施OCT对临床结局的影响及其对视觉相关生活质量(VRQoL)的影响。
    方法:一项观察性队列研究包括在德国开始玻璃体内抗血管内皮生长因子治疗的视网膜疾病患者。在12个月的观察期间,除了强制性的OCT检查外,治疗遵循临床实践。通过NEIVFQ-25评估VRQoL,并与不同疾病中的OCT检查和玻璃体内注射次数进行比较(nAMD,DME,BRVO,CRVO)。
    结果:1478例患者(74.5±10.9岁,54.9%的女性)被纳入分析。患者有新生血管性AMD(65.2%),DME(18.4%),BRVO(9.5%),或CRVO(6.9%)。在12个月内进行8.8±2.6OCT检查和6.1±3.2玻璃体内注射。基线时不同适应症之间的VRQoL不同,新生血管性AMD和CRVO的值明显较低。十二个月后,nAMD的视力和视觉功能量表增加,DME,和BRVO,仅在DME中,OCT检查次数与VRQoL之间存在相关性.
    结论:在现实环境中,玻璃体内治疗能够维持VRQoL超过12个月。12个月后,DME患者的定期OCT检查与VRQoL增加相关。
    The use of OCT to monitor intravitreal treatment varies in clinical practice and is not always mandatory. The ALBATROS data collection aimed to clarify the impact of routinely implemented OCT on clinical outcomes and its impact on vision-related quality of life (VRQoL).
    METHODS: An observational cohort study included patients with retinal diseases starting an intravitreal anti-vascular endothelial growth factor treatment in Germany. Treatment followed clinical practice except mandatory OCT examination during the 12-month observation period. VRQoL was assessed by NEI VFQ-25 and compared with respect to OCT examinations and number of intravitreal injections in the different diseases (nAMD, DME, BRVO, CRVO).
    RESULTS: 1478 patients (74.5 ± 10.9 years, 54.9% female) were included in the analysis. Patients had neovascular AMD (65.2%), DME (18.4%), BRVO (9.5%), or CRVO (6.9%). 8.8 ± 2.6 OCT examinations and 6.1 ± 3.2 intravitreal injections were performed within 12 months. VRQoL differed between indications at baseline, with substantially lower values for neovascular AMD and CRVO. After twelve months, an increase in visual acuity and visual functional scale was observed for nAMD, DME, and BRVO, while in DME only, there was an association between number of OCT examinations and VRQoL.
    CONCLUSIONS: Intravitreal treatment was able to maintain VRQoL over twelve months in a real-world setting. Regular OCT examinations were associated with higher gain in VRQoL in DME patients after 12 months.
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  • 文章类型: English Abstract
    BACKGROUND: Retinal vein occlusion, subdivided into central retinal and branch retinal vein occlusion, is one of the most frequent vascular diseases of the retina. Biomarkers of optical coherence tomography (OCT), OCT-angiography and (ultra-widefield) fluorescein angiography are of exceptional importance in the initial diagnosis and also in the treatment of complications associated with retinal vascular occlusion, particularly macular edema.
    METHODS: A systematic literature review was carried out in PubMed with the keywords central retinal vein occlusion, branch retinal vein occlusion, biomarker, OCT, OCT angiography, ultra-widefield fluorescein angiography with prioritization of the most important aspects.
    RESULTS: Relevant biomarkers in OCT include central retinal thickness (CRT), macular fluid, the integrity of the photoreceptor bands (external limiting membrane and ellipsoid zone), disorganization of retinal inner layers (DRIL), hyperreflective foci, choroidal thickness and signs of ischemia, such as a prominent middle limiting membrane (p-MLM), paracentral acute middle maculopathy (PAMM) as well as hyperreflectivity of inner retinal layers (HIRL). The importance of OCT-angiography lies particularly in the assessment of microvascular alterations, especially vessel density in the deep retinal vascular plexus, the foveal avascular zone and of areas with no capillary perfusion. Biomarkers of ultra-widefield angiography, such as peripheral ischemia (ischemic index) and neovascularízation are essential with respect to treatment decisions for retinal laser.
    CONCLUSIONS: A multitude of simple and complex biomarkers currently enable an effective individualized evaluation of treatment and prognosis in retinal vein occlusion. A shift from invasive to noninvasive biomarkers can be observed.
    UNASSIGNED: HINTERGRUND: Retinale Venenverschlüsse, subsumiert in Zentralvenen- und Venenastverschluss, gehören zu den häufigsten vaskulären Erkrankungen der Netzhaut. Sowohl bei Erstdiagnose als auch in der Therapie verschlussassoziierter Komplikationen, v. a. des Makulaödems, sind Biomarker der optischen Kohärenztomographie (OCT), OCT-Angiographie und (Ultraweitwinkel‑)Fluoreszeinangiographie von herausragender Bedeutung.
    METHODS: Es erfolgte eine systematische Literaturrecherche auf pubmed.gov mit den Keywords „central retinal vein occlusion“, „branch retinal vein occlusion“, „biomarker“, „OCT“, „OCT angiography“, „ultra-widefield fluorescein angiography“ mit Priorisierung der wichtigsten Aspekte zur Umfangsreduktion.
    UNASSIGNED: Als relevante Biomarker konnten in der OCT Makuladicke („central retinal thickness“ [CRT]), makuläre Flüssigkeit, die Integrität der Photorezeptorbande (Membrana limitans externa [ELM] und „ellipsoid zone“ [EZ]), „disorganization of retinal inner layers“ (DRIL), hyperreflektive Foci, Aderhautdicke sowie Ischämiezeichen wie „prominent middle limiting membrane“ (p-MLM), die „paracentral acute middle maculopathy“ (PAMM) sowie „hyperreflectivity of inner retinal layers“ (HIRL) identifiziert werden. Der Stellenwert der OCT-Angiographie liegt v. a. in der Beurteilung mikrovaskulärer Veränderungen, insbesondere der „vessel density“ im tiefen retinalen Gefäßplexus, der fovealen avaskulären Zone und von Arealen ohne Kapillarperfusion. Bezüglich der Therapieentscheidung zum Netzhautlaser sind Biomarker der Ultraweitwinkelangiographie wie periphere Ischämien („ischemic index“) sowie Neovaskularisationen essenziell.
    UNASSIGNED: Eine Vielzahl simplerer und komplexer Biomarker ermöglicht heute eine effektive individualisierte Therapie- und Prognoseeinschätzung beim retinalen Venenverschluss. Eine Verschiebung von invasiven zu nichtinvasiven Biomarkern wird beobachtet.
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  • 文章类型: Journal Article
    (1)背景:我们旨在评估中央和分支视网膜静脉阻塞(RVO)眼的脉络膜血管变化。(2)方法:在这项回顾性横断面研究中,我们回顾了47例近期发病患者的记录,天真,单侧视网膜静脉阻塞。使用ImageJ软件对深度增强成像光学相干断层扫描进行二值化;测量管腔面积(LA)和脉络膜总面积(TCA)。脉络膜血管分布指数(CVI)计算为LA与TCA的比例。根据黄斑水肿的类型,眼睛被分类为无黄斑水肿(nME),囊样黄斑水肿(CME),黄斑囊样水肿伴浆液性视网膜脱离(混合型)。(3)结果:CVI,TCA和LA在RVO的眼中比其他人更大,不受影响的眼睛除中央黄斑厚度(CMT)外,中央和分支RVO之间没有发现差异。与对照组相比,患有CME的眼睛在中央凹下脉络膜厚度上有显著增加,CMT,TCA,LA和CVI;混合性黄斑水肿的眼睛的CMT和CVI大于对侧眼睛;在nME的眼睛中没有观察到任何考虑参数的显着差异。(4)结论:结果表明,RVO改变了脉络膜的血管,根据黄斑水肿的类型而变化。
    (1) Background: we aimed to evaluate choroidal vascularity change in eyes with central and branch retinal vein occlusion (RVO). (2) Methods: in this retrospective cross-sectional study, we reviewed the records of 47 patients with recent-onset, naïve, unilateral retinal vein occlusion. Enhanced-depth imaging optical coherence tomography scans were binarized using the ImageJ software; luminal area (LA) and total choroidal area (TCA) were measured. The choroidal vascularity index (CVI) was calculated as the proportion of LA to TCA. Depending on the pattern of macular oedema, eyes were classified as having no macular oedema (nME), cystoid macular oedema (CME), cystoid macular oedema with serous retinal detachment (mixed). (3) Results: CVI, TCA and LA were greater in eyes with RVO than in fellow, unaffected eyes. No difference was found between central and branch RVO except for central macular thickness (CMT). When compared with controls, eyes with CME presented a significant increase in subfoveal choroidal thickness, CMT, TCA, LA and CVI; eyes with mixed macular oedema had greater CMT and CVI than contralateral eyes; no significant differences in any of the considered parameters were observed in eyes with nME. (4) Conclusions: The results suggest that RVO alters the vascularity of the choroid that varies according to the type of macular oedema.
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