The mean platelet volume in patients with retinal vein occlusion.
Sahin Alparslan,Sahin Muhammed,Yüksel Harun,Türkcü Fatih Mehmet,Cınar Yasin,Cingü Abdullah Kürşat,Arı Seyhmus,Caça Ihsan
Journal of ophthalmology
Background. The aim of this study was to investigate the mean platelet volume (MPV) of patients with retinal vein occlusion (RVO). Methods. Hundred and ninty-three patients with the diagnosis of RVO and 83 healthy control subjects were included in this retrospective study. Retinal vein occlusion was diagnosed based on clinical examination. All patients and control subjects underwent complete ocular examination. MPV, hematocrit, hemoglobin, and platelet count of the participants were recorded. The data of patients with RVO was compared with the control subjects. Results. Patients with RVO had significantly higher MPV values (8.19 ± 1.22 fL) compared with the control subjects (7.68 ± 1.11 fL) (P = 0.004). No significant difference was found in platelet counts between RVO group and the control group (275.77 ± 70.87 10(9)/L and 261.96 ± 59.40 10(9)/L, resp., P = 0.161), Mean platelet volume was an independent predictor of RVO (odds ratio (OR) = 1.43; 95% confidence interval (CI) = 1.09-1.89; P = 0.011). Conclusion. Our results demonstrated that the MPV values were significantly higher in patients with RVO, suggesting that larger platelets may contribute to the pathogenesis of the RVOs.
10.1155/2013/236371
EVALUATION OF MACULAR ISCHEMIA IN EYES WITH CENTRAL RETINAL VEIN OCCLUSION: An Optical Coherence Tomography Angiography Study.
Ghashut Rima,Muraoka Yuki,Ooto Sotaro,Iida Yuto,Miwa Yuko,Suzuma Kiyoshi,Murakami Tomoaki,Kadomoto Shin,Tsujikawa Akitaka,Yoshimura Nagahisa
Retina (Philadelphia, Pa.)
PURPOSE:To quantitatively assess macular perfusion status using optical coherence tomography angiography in eyes with aflibercept-treated central retinal vein occlusion and resolved macular edema and to investigate the impact of macular morphology and perfusion status on visual function. METHODS:This prospective consecutive case series included 23 patients with central retinal vein occlusion. All patients received intravitreal aflibercept injections before analysis. Visual acuity, macular sensitivity, and the macular nonperfusion area (NPA) were evaluated in eyes without macular edema. The macular NPA was evaluated by optical coherence tomography angiography using 3 mm × 3 mm images of the macula. Foveal ellipsoid zone disruption was also analyzed. RESULTS:The superficial macular NPA measured 4.15 mm ± 0.71 mm (95% confidence interval 3.85-4.46), and the deep macular NPA measured 4.23 mm ± 0.97 mm (95% confidence interval 3.82-4.56). The logarithm of the minimum angle of resolution visual acuity was significantly associated with foveal ellipsoid zone disruption (P = 0.001), the superficial macular NPA (P = 0.015), and the deep macular NPA (P = 0.018). Macular sensitivity correlated negatively with logarithm of the minimum angle of resolution visual acuity (P = 0.007), the superficial macular NPA (P = 0.029), and the deep macular NPA (P = 0.040), but not with the foveal ellipsoid zone disruption (P = 0.435). CONCLUSION:Optical coherence tomography angiography is a novel technique that enables segmented evaluation of the macular perfusion status in eyes with central retinal vein occlusion and provides visual prognostic information. Enlargement of the macular NPA in the superficial and deep layers was significantly correlated with impaired visual acuity and with decreased macular sensitivity in patients with aflibercept-treated central retinal vein occlusion and resolved macular edema.
10.1097/IAE.0000000000001749
Can Rotational Thromboelastometry be a New Predictive Tool for Retinal Vein Occlusion Development?
Goren Sahin Deniz,Bayraktutar Betül N,Yıldız Taş Ayşe,Akay Olga Meltem,Ozkaya Abdullah,Yalcin Özlem,Sahin Afsun
Current eye research
PURPOSE:To evaluate clotting dynamics by a new tool called rotational tromboelastometry (ROTEM) in retinal vein occlusion. MATERIALS AND METHODS:Thirty-six patients who were diagnosed with retinal vein occlusion and 43 age and sex matched healthy controls were included in this study. Diabetes and use of anticoagulant therapy were exclusion criteria. All study participants underwent detailed ophthalmologic and systemic medical examination, including blood pressure measurement, hemoglobin-hematocrit levels, platelet count, coagulation parameters including prothrombin time, activated partial thromboplastin time, fibrinogen levels, and D-dimer levels. Peripheral blood samples were collected and analyzed with ROTEM Coagulation Analyzer (Tem International, Munich, Germany). RESULTS:The RVO patients and controls did not differ with respect to age, sex, hemoglobin, hematocrit, platelet numbers, prothrombin time, activated partial thromboplastin time, fibrinogen levels, D-dimer levels, and glucose levels. When extrinsic thromboelastometry results were analyzed, RVO patients showed a significantly decreased clotting time (76.5 ± 15.0 vs. 95.0 ± 21 s, respectively; p = 0.01) and clot formation time (83.3 ± 22 vs. 99.7 ± 24s; p = 0.01) as compared with healthy controls. Other ROTEM parameters did now show any difference between two groups. CONCLUSION:Patients with retinal vein occlusion showed faster clotting time and shorter clotting formation time as compared with healthy controls. ROTEM detects the altered clotting dynamics and may be a useful tool to elucidate the disease pathophysiology. Further studies are needed to investigate if it can be used as a screening test for individuals who are under risk to develop RVO or as a first step test to evaluate hypercoagulable state in RVO.
10.1080/02713683.2018.1554152
Angiotensin (1-7) through modulation of the NMDAR-nNOS-NO pathway and serotonergic metabolism exerts an anxiolytic-like effect in rats.
Zhu Donglin,Sun Ming,Liu Qinqin,Yue Yu,Lu Jie,Lin Xingjian,Shi Jingping
Behavioural brain research
Although recent studies have shown that angiotensin (1-7) (Ang [1-7]) exerts anti-stress and anxiolytic-like effects, the underlying mechanisms remain elusive. The ventral hippocampus (VH) is proposed to be a critical brain region for mood and stress management through the N-methyl-d-aspartate receptor (NMDAR) signaling pathway. However, the role of VH NMDAR signaling in the effects of Ang (1-7) remains unclear. In the present study, Ang (1-7) was injected into the bilateral VH of stressed rats, or in combination with a Fyn kinase inhibitor, NMDAR antagonist, neuronal nitric oxide synthase (nNOS) inhibitor, or nitric oxide (NO) scavenger. Anxiety-like behaviors were assessed using the open field test and elevated plus maze test, while alterations in NMDAR-nNOS-NO signaling and serotonergic metabolism were examined in the VH. After 21 days of chronic restraint stress, anxiety-like behaviors were evident. Levels of phosphorylated NR2B (a key NMDAR subunit), its upstream kinase Fyn, as well as activity of nNOS and monoamine oxidase (MAO) were markedly reduced. In contrast, levels of serotonin were increased. Bilateral VH infusion of Ang (1-7) recovered NMDAR-nNOS-NO signaling and MAO-mediated serotonin metabolism, as well as reducing anxiety-like behaviors in stressed rats. These effects were diminished by blockade of MasR (Ang [1-7]-specific receptor), Fyn kinase, NMDAR, nNOS, or NO production. Altogether, these findings indicate that Ang (1-7) exerts anxiolytic effects through modulation of the NMDAR-nNOS-NO pathway and serotonergic metabolism. Future translational research should focus on the relationship between Ang (1-7), glutamatergic neurotransmission, and serotonergic neurotransmission in the VH.
10.1016/j.bbr.2020.112671
Central Retinal Vein Occlusion Resolving After Orbital Decompression in Thyroid Eye Disease.
Grob Seanna R,Yoon Michael K
Ophthalmic plastic and reconstructive surgery
A 49-year-old male presented with proptosis and was found to have optic nerve edema with peripapillary hemorrhages. Diagnostic testing showed a suppressed thyroid-stimulating hormone. CT orbits showed homogenous tendon-sparing enlargement of the medial and inferior rectus muscles, characteristic of thyroid eye disease. Intravenous methylprednisolone was administered given the concern for compressive optic neuropathy. He initially had improvement of his symptoms, so orbital decompression was deferred. Subsequently he presented with worsening diplopia and right proptosis, a new afferent pupillary defect, and a cecocentral visual field defect. Dilated examination revealed significant optic nerve head edema and diffuse retinal hemorrhages in all 4 quadrants consistent with a central retinal vein occlusion. The patient underwent an urgent 3-wall orbital decompression on the right. Close follow up postoperatively showed resolution of the central retinal vein occlusion and the associated optic disc edema, peripapillary hemorrhages, and macular edema. Orbital decompression is known to improve many manifestations of thyroid eye disease, but this is the first report of orbital decompression resulting in resolution of a central retinal vein occlusion.
10.1097/IOP.0000000000000635
Neutrophil/lymphocyte ratio and mean platelet volume in branch retinal vein occlusion.
Turkseven Kumral Esra,Yenerel Nursal Melda,Ercalik Nimet Yesim,Imamoglu Serhat,Vural Ece Turan
Saudi journal of ophthalmology : official journal of the Saudi Ophthalmological Society
PURPOSE:To evaluate the mean platelet volume (MPV) and the neutrophil/lymphocyte ratio (NLR) in patients with branch retinal vein occlusion (BRVO). METHODS:Thirty patients with branch retinal vein occlusion (BRVO group) and 27 age and sex matched subjects (control group) were included in the study. MPV and NLR parameters obtained from peripheral blood were recorded. RESULTS:The mean age was 62.6 ± 12.3 years in BRVO and 63.5 ± 8.2 years in control group. The BRVO group consisted of 13 males and 17 females and the control group included 12 male and 15 female subjects. The mean MPV values were 8.64 ± 2.01 fL in BRVO group and 8.5 ± 1.26 fL in control group. NLR was 2.24 ± 0.79 and 1.89 ± 0.64 in BRVO and control groups respectively. The difference between two groups in terms of MPV and NLR was not statistically significant. CONCLUSION:MPV and NLR were found to be not affected in branch retinal vein occlusion patients.
10.1016/j.sjopt.2016.02.003
Elevated lipocalin-2 level in aqueous humor of patients with central retinal vein occlusion.
Koban Yaran,Sahin Seda,Boy Fatih,Kara Fatih
International ophthalmology
PURPOSE:To assess the concentrations of lipocalin-2 (LCN2) in the serum and the aqueous humor of patients with central retinal vein occlusion (CRVO). METHODS:The concentrations of LCN2 in the serum and aqueous humor of 16 cataract patients and 16 patients with CRVO with macular edema were compared. Collection of aqueous samples was conducted in the operating theater under sterile conditions and just prior to intravitreal ranibizumab injection or cataract surgery. LCN2 levels in serum and aqueous humor samples were measured using a commercial kit (human lipocalin-2/NGAL PicoKine ELISA Kit, MyBioSource Inc., USA; Catalog No: MBS175829) based on standard sandwich enzyme-linked immunosorbent assay technology. RESULTS:The concentrations of LCN2 in the aqueous humors of the CRVO group were higher than those of the control group (p = 0.021). There was no significant difference in serum LCN2 level between the two groups (p = 0.463). CONCLUSIONS:Concentrations of LCN2 in aqueous humor are increased in CRVO. LCN2 may be part of a pro-catabolic phenotype, and it may play an important role in the dreaded complications of CRVO, such as macular edema, macular ischemia, and neovascularization, which lead to blindness.
10.1007/s10792-018-0894-2
Aqueous semaphorin 3A level correlates with retinal macular oedema and ganglion cell degeneration in patients with retinal vein occlusion.
Guo Shengxiang,Ren Jiawei,Li Zhengli,Fan Xiaojuan,Qin Li,Li Jingming
Acta ophthalmologica
PURPOSE:To investigate the semophorin 3A (SEMA3A) level in aqueous humor of patients with retinal vein occlusion (RVO) and explore the correlation of SEMA3A with macular oedema and ganglion cell degeneration in RVO. METHODS:This comparative study prospectively included 41 consecutive patients (41 eyes) with RVO who had intravitreal anti-VEGF injections from March 2014 to March 2015 for cystoid macular oedema (CME) or neovascular glaucoma (NVG). The patients were divided into three groups according to the fluorescein angiograghy (FFA): central retinal vein occlusion (CRVO) group (n = 15), branch retinal vein occlusion (BRVO) group (n = 15) and NVG group (secondary to CRVO, n = 11). The patients who had undergone cataract surgery (n = 16) during the same period served as controls. The SEMA3A concentration in aqueous humor collected before the initial anti-VEGF injection was determined by enzyme-linked immunosorbent assay (ELISA). Central retinal thickness (CRT), cube volume (CV) and ganglion cell-inner plexiform layer (GC-IPL) thickness was analysed by spectral-domain optical coherence tomography (SD-OCT). RESULTS:Semaphorin 3A level in CRVO group (1.52 ± 1.23 ng/ml) and NVG group (1.67 ± 0.98 ng/ml) were significantly higher than the control group (0.66 ± 0.58 ng/ml; both p < 0.05). Moreover, SEMA3A level in CRVO group was higher than BRVO group (1.52 ± 1.23 ng/ml versus 0.53 ± 0.37 ng/ml; p < 0.05). SEMA3A level was positively correlated with CRT and CV in both BRVO group (CRTr = 0.6535, p = 0.0082; CVr = 0.5190, p = 0.0474) and CRVO group (CRTr = 0.6270, p = 0.0124; CVr = 0.6898, p = 0.0044). In RVO patients, the GC-IPL thickness of affected eyes were significantly reduced compared with the normal follow eyes (CRVOt = 4.55, p = 0.006; BRVOt = 4.54, p = 0.004). Meanwhile, negative correlation of SEMA3A level with GC-IPL thickness was found in both BRVO group (r = -0.5906, p = 0.0205) and CRVO group (r = -0.6100, p = 0.0157). CONCLUSION:Semaphorin 3A level is increased in aqueous humor of RVO patients. Positive correlation of CRT as well as negative correlation of GC-IPL thickness with SEMA3A may suggest a pathological role of SEMA3A in macular oedema and ganglion cell degeneration during RVO.
10.1111/aos.14079
Predictors of Neovascular Glaucoma in Central Retinal Vein Occlusion.
Rong Andrew J,Swaminathan Swarup S,Vanner Elizabeth A,Parrish Richard K
American journal of ophthalmology
PURPOSE:To determine the risk factors for development of neovascular glaucoma (NVG) in patients after an acute central retinal vein occlusion (CRVO). DESIGN:Retrospective cohort study. METHODS:Review of medical records of 646 patients with a diagnosis of CRVO between 2013 and 2017 at the Bascom Palmer Eye Institute. INCLUSION CRITERIA:(1) CRVO onset to presentation <90 days; (2) absence of anterior segment neovascularization on presentation; (3) no intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection before presentation. Patients meeting inclusion criteria were screened for potential risk factors for development of NVG. Risk of developing NVG was assessed with Kaplan-Meier survival analysis and Cox proportional hazards models. RESULTS:Thirteen of 98 patients (13%) who met inclusion criteria developed NVG. The mean adjusted time to NVG diagnosis from onset of CRVO-related symptoms was 212 days. Patients presenting with a worse initial visual acuity (P = .034), a relative afferent pupillary defect (RAPD) (P = .002), or a history of systemic hypertension (P = .026) had an increased risk of NVG compared to those who did not. Age, body mass index, history of glaucoma, history of diabetes, and central retinal thickness were not significantly associated with development of NVG. CONCLUSIONS:Risk factors for NVG development included history of systemic hypertension, worse visual acuity on presentation, and RAPD on presentation. Patients presenting with these findings should be followed at closer intervals and informed of the greater risk for neovascularization. Intravitreal anti-VEGF therapy delayed but did not prevent NVG.
10.1016/j.ajo.2019.02.038
Mean platelet volume and central retinal vein occlusion in hypertensive patients.
Bawankar Pritam,Samant Preetam,Lahane Tatyarao,Parekh Ragini,Lahane Sayalee
Canadian journal of ophthalmology. Journal canadien d'ophtalmologie
OBJECTIVE:To study the relationship between mean platelet volume (MPV) and central retinal vein occlusion (CRVO) in hypertensive patients. DESIGN:Hospital-based, retrospective, case control design. PARTICIPANTS:The sample group consisted of 100 patients with a known history of hypertension and who are diagnosed with CRVO. The control group consisted of 100 age and sex-matched patients with the sample group and who had a sole history of hypertension without any other systemic diseases and the best corrected visual acuity of 20/20 in both the eyes. METHODS:CRVO was diagnosed based on clinical examination. All cases and control subjects underwent complete ocular examination. MPV, platelet count, hemoglobin, white blood cell count and hematocrit parameters were recorded for both groups. The data of patients with CRVO was compared with the control subjects. Confidence interval was set at 95% with a P-value of < 0.05. RESULTS:MPV was significantly higher among hypertensive cases diagnosed with CRVO when compared with the hypertensive control group (8.059 ± 0.016, 7.442 ± 0.15 fL respectively; P < 0.001). The platelet count was lower in the control group, but the difference was not significant. The systolic blood pressure was significantly higher in the sample group. CONCLUSIONS:Our results demonstrated that MPV values were significantly higher in patients with CRVO, suggesting that increased MPV may contribute to the development of CRVO.
10.1016/j.jcjo.2018.04.014
Hypoxia tolerance and retinal vein occlusion: a pilot evaluation.
Mauget-Faysse M,Germain-Pastene M
European journal of ophthalmology
PURPOSE:To determine if hypoxia tolerance in patients with retinal vein occlusion (RVO) following exposure to transient hypoxia is different from the hypoxia tolerance of healthy patients without retinal vein occlusion. METHODS:Consecutive patients presenting with RVO following exposure to transient hypoxia (Group I) were compared with healthy subjects (Group II). In addition to cardiovascular and plasma tests, functional respiratory evaluation was performed at rest and during exercise at both normal oxygen levels (21% O2) and in hypoxia (11.6% O2). We used the Wilcoxon test for statistical analysis. RESULTS:Both groups of eight males had similar mean ages: Group I, 47.5 years and Group II, 53 years. In Group I, three patients had glucose or lipid abnormalities, one had hypertension, and one minor thalassanemia. In Group II, one patient had hypertension. At rest in hypoxia, the oxyhemoglobinic desaturation was significantly different (p=0.03) in Group I in comparison with Group II (-13.8 versus -9.3). At exercise in hypoxia, the oxyhemoglobinic desaturation was similar in both groups but there was a statistically significant increase in both systolic (189 versus 155 mmHg; p=0.01) and diastolic (94 versus 77 mmHg; p=0.03) blood pressure in Group I. Ventilation rate and increased heart rate during hypoxia were higher in Group I compared with Group II but were not statistically significant. CONCLUSIONS:In our pilot study, patients with RVO following exposure to transient hypoxia demonstrated intolerance to hypoxia and were significantly different from healthy subjects in their response to hypoxia. A larger study is required to confirm these preliminary results.
Hematologic abnormalities associated with various types of retinal vein occlusion.
Hayreh Sohan Singh,Zimmerman M Bridget,Podhajsky Patricia
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie
BACKGROUND:The objective of this study was two-fold: (1) to investigate hematologic abnormalities associated with various types of retinal vein occlusion (RVO) and comparison of their prevalence among those various types of RVO; (2) to review the conflicting literature on the subject, to place the information in perspective. METHODS:In patients with various types of RVO seen in our clinic since 1973, we conducted planned prospective studies on the prevalence of: (1) routine hematologic tests (535 patients) and (2) certain special hematologic parameters (platelet aggregation, antithrombin III, and proportional, variant(2) globulin in 110, 81 and 91 patients, respectively). Patients were categorized into six types of RVO, based on defined criteria: non-ischemic and ischemic central RVO (CRVO), non-ischemic and ischemic hemi-CRVO (HCRVO), and major and macular branch RVO (BRVO). The patients had a detailed ophthalmic, systemic and hematologic evaluation. The data were abstracted and analyzed retrospectively from the detailed information originally collected prospectively in the patients' records. For data analysis, patients were divided into young, middle-aged and elderly. Observed prevalence rates of hematologic abnormalities were estimated. Logistic regression, adjusting for age and gender, was used to compare the observed prevalence of hematologic abnormalities among the various types of RVO. RESULTS:No generalizations about the prevalence of hematologic disorders in all six types of RVO are possible. Ischemic CRVO showed a significantly higher prevalence of abnormal hematocrit ( P=0.044), hemoglobin ( P=0.018), and blood urea nitrogen ( P=0.025) than non-ischemic CRVO, while a significantly higher prevalence of abnormal antinuclear antibody (ANA; P=0.049) was seen in non-ischemic CRVO than in ischemic CRVO. There was a significant ( P=0.011) difference in the prevalence of abnormal uric acid among the three main RVO groups (CRVO, HCRVO, BRVO), highest in BRVO and lowest in HCRVO. There was a higher prevalence of abnormal glucose ( P=0.069) and ANA ( P=0.071) in CRVO+HCRVO than in BRVO. Results of special hematologic studies are given. CONCLUSIONS:Our study showed that a variety of hematologic abnormalities may be seen in association with different types of RVO, and any generalization about these disorders applied to all RVO patients may be misleading. The evidence of our study and in the literature indicates that there is no good reason why all patients with RVO should be subjected to extensive, expensive, special hematologic and hypercoagulability investigations, unless, of course, there is some clear indication; the routine, inexpensive hematologic evaluation is usually sufficient for RVO patients. Treatment with anticoagulants or platelet anti-aggregating agents may adversely influence the visual outcome, without any evidence of protective or beneficial effect.
10.1007/s00417-001-0421-3
Axial length, a risk factor for retinal vein occlusion: A case control study.
Ghoghari Hunain,Rizvi Syed Fawad,Loya Hina,Razzak Kaunain
JPMA. The Journal of the Pakistan Medical Association
OBJECTIVE:To evaluate the role of axial length in cases of retinal vein occlusion. METHODS:The case-control study was conducted at Layton Rahmatullah Benevolent Trust Eye Hospital, Karachi, from March to August 2018, and comprised patients with retinal vein occlusion and age-matched controls. Axial length of both eyes of all the subjects was calculated. The length of the affected eye was compared with that of the contralateral unaffected eye and also with the controls. Data was analysed using SPSS 21. RESULTS:There were 70 subjects; 35(50%) in each of the two groups. Among the cases, 16(46%) were males and 19(54%) were females. The overall mean age of the group was 37}4.2 years. Among the controls, 21(60%) were males and 14(40%) were females. The mean age of the group was 36.5}4.5 years. Also, among the cases, 23(66%) had unilateral central retinal vein occlusion and 12(34%) had branch retinal vein occlusion. Mean axial length was 0.80mm shorter in central retinal vein occlusion patients and controls (p=0.01). Branch retinal vein occlusion group did not show statistical significance on comparing with fellow eyes (p=0.18) and with controls (p=0.07). CONCLUSIONS:Axial length was found to be a local predisposing factor to develop retinal vein occlusion.
10.5455/JPMA.6579