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Graefe's Archive for Clinical and Experimental Ophthalmology

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01-11-2017 | Retinal Disorders

Short-term results of endovascular surgery with tissue plasminogen activator injection for central retinal vein occlusion

Authors: Masaaki Ishida, Shinya Abe, Takuya Nakagawa, Atsushi Hayashi

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 11/2017

Abstract

Purpose

To examine the effects of retinal endovascular surgery (REVS) with tissue plasminogen activator injection into the retinal vein in central retinal vein occlusion (CRVO) eyes.

Methods

Sixteen consecutive CRVO patients with macular edema and decreased visual acuity who were referred to Toyama University Hospital between March 2014 and February 2016 were included in this study. Changes in visual acuity (VA) and central retinal thickness (CRT) were evaluated up to 6 months after REVS. Staining and leakage of the retinal veins in fluorescein angiography (FA) was graded in nine patients.

Results

Ten of 16 eyes were determined to be non-ischemic while the remaining six were ischemic. The mean logarithm of the minimum angle of resolution (logMAR) of VA was significantly improved from 0.98 ± 0.58 (mean ± standard deviation) at baseline to 0.78 ± 0.61 at 3 months (p = 0.002), and 0.64 ± 0.60 at 6 months (p = 0.003) after REVS. At 6 months, VA was improved in eight eyes (50%), while the other eight (50%) showed no change; none showed worsening. In the 10 eyes with non-ischemic CRVO, the mean VA was significantly improved at 6 months (p = 0.002), whereas no improvement was found in the six eyes with ischemic CRVO, . In all eyes, the mean CRT was significantly improved from 804 ± 343 μm at baseline to 506 ± 304 μm at 2 months (p = 0.014), 332 ± 229 μm at 3 months (p = 0.0001), and 305 ± 235 μm at 6 months (p = 0.00001). The postoperative complications observed were prolonged vitreous hemorrhage in one eye and neovascular glaucoma in two eyes. For postoperative recurrence of macular edema, sub-tenon injection of triamcinolone acetonide was given to five eyes, and intravitreal injection of an anti-VEGF agent was given to five eyes. Pan-retinal photocoagulation was performed on six eyes with ischemic type CRVO. The FA score was significantly improved after REVS (p = 0.018).

Conclusions

REVS using a specially made micro-needle may be a surgical treatment option for non-ischemic CRVO, but it did not seem effective for ischemic CRVO.

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Title: Short-term results of endovascular surgery with tissue plasminogen activator injection for central retinal vein occlusion
Authors: Masaaki Ishida
Shinya Abe
Takuya Nakagawa
Atsushi Hayashi
Publication date: 01-11-2017
Publisher: Springer Berlin Heidelberg
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 11/2017
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-017-3763-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Short-term results of endovascular surgery with tissue plasminogen activator injection for central retinal vein occlusion

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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