Retinal vein occlusion: pathophysiology and treatment options

Niral Karia, Niral Karia

Abstract

This paper reviews the current thinking about retinal vein occlusion. It gives an overview of its pathophysiology and discusses the evidence behind the various established and emerging treatment paradigms.

Keywords: branch; central; hemispheric; retinal vein occlusion; visual loss.

References

    1. Cugati S, Wang JJ, Rochtchina E, et al. Ten-year incidence of retinal vein occlusion in an older population: the Blue Mountains Eye Study. Arch Ophthalmol. 2006;124:726–732.
    1. Hayreh S. Prevalent misconceptions about acute retinal vascular occlusive disorders. Prog Retinal Eye Res. 2005;24:493–519.
    1. Cheung N, Klein R, Wang J, et al. Traditional and novel cardiovascular risk factors for retinal vein occlusion: the multiethnic study of atherosclerosis. Invest Ophthalmol Vis Sci. 2008;49:4297–4302.
    1. Klein R, Moss SE, Meuer SM, Klein BE. The 15-year cumulative incidence of retinal vein occlusion: the Beaver Dam Eye Study. Arch Ophthalmol. 2008;126:513–518.
    1. Dexamethasone 700 μg intravitreal implant in applicator for retinal vein occlusion. Allergan advance notification document. 2009 Oct.
    1. Dexamethasone Intravitreal Implant Approved for Retinal Vein Occlusion. Medscape Medical News. Available from: Accessed on March 1, 2010.
    1. 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. 2010;117:313–319.
    1. Green WR, Chan CC, Hutchins GM, et al. Central retinal vein occlusions: A prospective histopathologic study of 29 eyes in 28 cases. Retina. 1981;1:27–55.
    1. The Eye Disease Case-Control Study Group Risk factors for central retinal vein occlusion. Arch Ophthalmol. 1996;114:545–554.
    1. Sperduto RD, Hiller R, Chew E, et al. Risk factors for hemiretinal vein occlusion: comparison with risk factors for central and branch retinal vein occlusion: the eye disease case-control study. Ophthalmology. 1999;106:439–440.
    1. The Eye Disease Case-Control Study Group Risk factors for branch retinal vein occlusion. Am J Ophthalmol. 1993;116:286–296.
    1. O’Mahoney P, Wong T, Ray J. Retinal vein occlusion and traditional risk factors for atherosclerosis. Arch Ophthalmol. 2008;126:692–699.
    1. Koizumi H, Ferrara D, Brue C, et al. Central retinal vein occlusion case-control study. Am J Ophthalmol. 2007;144:858–863.
    1. Fegan CD. Central retinal vein occlusion and thrombophilia. Eye. 2002;16:98–106.
    1. Janssen MC, den Heijer M, Cruysberg JR, Wollersheim H, Bredie SJ. Retinal vein occlusion: a form of venous thrombosis or a complication of atherosclerosis? A meta-analysis of thrombophilic factors. Thromb Haemost. 2005;93:1021–1026.
    1. Salaun N, Delyfer MN, Rougier MB, Korobelnik JF. Assessment of risk factors for retinal vein occlusions in patients under 60 years of age. J Fr Ophtalmol. 2007;30:918–923.
    1. Turello M, Pasca S, Daminato R, et al. Retinal vein occlusion: evaluation of “classic” and “emerging” risk factors and treatment. J Thromb Thrombolysis. 2010;29:459–464.
    1. Klein BE, Meuer SM, Knudtson MD, Klein R. The relationship of optic disk cupping to retinal vein occlusion: the Beaver Dam Eye Study. Am J Ophthalmol. 2006;141:859–862.
    1. Girmens JF, Scheer S, Heron E, et al. Familial central retinal vein occlusion. Eye. 2008;22:308–310.
    1. Bhagat N, Goldberg MF, Gascon W, et al. Central retinal vein occlusion: report of two familial cases. Eur J Ophthalmol. 1999;9:181–195.
    1. Campochiaro PA, Hafiz G, Shah SM, et al. Ranibizumab for macular edema due to retinal vein occlusion: implication of VEGF as a critical stimulator. Mol Ther. 2008;16:791–799.
    1. Yoshimura T, Sonoda KH, Sugahara M, et al. Comprehensive analysis of inflammatory immune mediators in vitreoretinal diseases. PLoS ONE. 2009;4(12):e8158.
    1. Funk M, Kriechbaum K, Prager F, et al. Intraocular concentrations of growth factors and cytokines in retinal vein occlusion and the effect of therapy with bevacizumab. Invest Ophthalmol Vis Sci. 2009;50:1025–1032.
    1. Aiello LP, Avery RL, Arrigg PG, et al. Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med. 1994;331:1480–1487.
    1. Ozaki H, Hayashi H, Vinores SA, Moromizato Y, Campochiaro PA, Oshima K. Intravitreal sustained release of VEGF causes retinal neo-vascularization in rabbits and breakdown of the blood-retinal barrier in rabbits and primates. Exp Eye Res. 1997;64:505–517.
    1. Noma H, Funatsu H, Yamasaki M, et al. Pathogenesis of macular edema with branch retinal vein occlusion and intraocular levels of vascular endothelial growth factor and interleukin-6. Am J Ophthalmol. 2005;140:256–261.
    1. Noma H, Funatsu H, Yamasaki M, et al. Aqueous humour levels of cytokines are correlated to vitreous levels and severity of macular edema in branch retinal vein occlusion. Eye. 2008;22:42–48.
    1. Noma H, Funatsu H, Mimura T, Harino S, Sone T, Hori S. Increase of vascular endothelial growth factor and interleukin-6 in the aqueous humour of patients with macular edema and central retinal vein occlusion. Acta Ophthalmol. Epub 2009 Jun 26.
    1. Noma H, Funatsu H, Mimura T, Harino S, Hori S. Vitreous levels of interleukin-6 and vascular endothelial growth factor in macular edema with central retinal vein occlusion. Ophthalmology. 2009;116:87–93.
    1. Boyd SR, Zachary I, Chakravarthy U, et al. Correlation of increased vascular endothelial growth factor with neovascularization and permeability in ischemic central vein occlusion. Arch Ophthalmol. 2002;120:1644–1650.
    1. The Branch Vein Occlusion Study Group Argon laser photocoagulation for macula edema in branch vein occlusion. Am J Ophthalmol. 1984;98:271–282.
    1. The Branch Vein Occlusion Study Group Argon laser scatter photocoagulation for prevention of neovascularization and vitreous hemorrhage in branch vein occlusion. Arch Ophthalmol. 1986;104:34–41.
    1. The Central Vein Occlusion Study Group Evaluation of grid pattern photocoagulation for macular edema in central vein occlusion. Ophthalmology. 1995;102:1425–1433.
    1. The Central Vein Occlusion Study Group A randomized clinical trial of early panretinal photocoagulation for ischemic central vein occlusion. Ophthalmology. 1995;102:1434–1444.
    1. Rogers SL, McIntosh RL, Lim L, et al. Natural history of branch retinal vein occlusion: An evidence-based systematic review. Ophthalmology. 2010;117:1094–1101.e5.
    1. Mohamed Q, McIntosh RL, Saw SM, Wong TY. Interventions for central retinal vein occlusion: an evidence-based systematic review. Ophthalmology. 2007;114:507–519.
    1. Squizzato A, Manfredi E, Bozzato S, et al. Antithrombotic and fibrinolytic drugs for retinal vein occlusion: A systematic review and a call for action. Thromb Haemost. 2010;103:271–276.
    1. Lazo-Langner A, Hawel J, Ageno W, Kovacs MJ. Low molecular weight heparin for the treatment of retinal vein occlusion: a systematic review and meta-analysis of randomized trials. Haematologica. 2010 Mar 19; [Epub ahead of print]
    1. Mandelcorn MS, Nrusimhadevara RK. Internal limiting membrane peeling for decompression of macular edema in retinal vein occlusion: a report of 14 cases. Retina. 2004;24:348–355.
    1. Opremcak EM, Bruce RA, Lomeo MD, et al. Radial optic neurotomy for central retinal vein occlusion: a retrospective pilot study of 11 consecutive cases. Retina. 2001;21:408–415.
    1. Weizer JS, Stinnett SS, Fekrat S. Radial optic neurotomy as treatment for central retinal vein occlusion. Am J Ophthalmol. 2003;136:814–819.
    1. Weiss JN. Treatment of central retinal vein occlusion by injection of tissue plasminogen activator into a retinal vein. Am J Ophthalmol. 1998;126:142–144.
    1. Bynoe LA, Hutchins RK, Lazarus HS, Friedberg MA. Retinal endovascular surgery for central retinal vein occlusion: initial experience of four surgeons. Retina. 2005;25:625–632.
    1. McAllister IL, Gillies M, Smithies LA, et al. The central retinal vein bypass study: A trial of laser-induced chorioretinal venous anastomosis for central retinal vein occlusion. Opthalmology. 2010;117:954–965.
    1. McIntosh RL, Mohamed Q, Saw SM, Wong TY. Interventions for branch retinal vein occlusion: an evidence-based systematic review. Ophthalmology. 2007;114:835–854.
    1. Arnarsson A, Stefansson E. Laser treatment and the mechanism of edema reduction in branch retinal vein occlusion. Invest Opthalmol Vis Sci. 2000;41:877–879.
    1. Muqit MM, Saidkasimova S, Keating D, Murdoch JR. Long-term study of vascular perfusion effects following arteriovenous sheathotomy for branch retinal vein occlusion. Acta Ophthalmol. 2010;88:e57–e65.
    1. Park CH, Jaffe GJ, Fekrat S. Intravitreal triamcinolone acetonide in eyes with cystoid macular edema associated with central retinal vein occlusion. Am J Ophthalmol. 2003;136:419–425.
    1. Ip MS, Gottlieb JL, Kahana A, et al. Intravitreal triamcinolone for the treatment of macular edema associated with central retinal vein occlusion. Arch Ophthalmol. 2004;122:1131–1136.
    1. Patel PJ, Zaheer I, Karia N. Intravitreal triamcinolone acetonide for macular edema owing to retinal vein occlusion. Eye. 2008;22:60–64.
    1. Miyamoto N, Iossifov D, Metge F, Behar-Cohen F. Early effects of intravitreal triamcinolone on macular edema. Ophthalmology. 2006;113:2048–2053.
    1. The SCORE Study Research Group A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with observation to treat vision loss associated with macular edema secondary to central retinal vein occlusion: the standard care vs corticosteroid for retinal vein occlusion (SCORE) Study Report 5. Arch Ophthalmol. 2009;127:1101–1114.
    1. The SCORE Study Research Group A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with standard care to treat vision loss associated with macular edema secondary to branch retinal vein occlusion: the standard care vs corticosteroid for retinal vein occlusion (SCORE) Study Report 6. Arch Ophthalmol. 2009;127:1115–1128.
    1. Apte RS. SCOREing in retinal venous occlusive disease. Arch Ophthalmol. 2009;127:1203–1204.
    1. Loewenstein A, Haller J, Bandello F, et al. 12-month evaluation of an applicator-delivered dexamethasone intravitreal implant in patients with macular edema due to branch or central retinal vein occlusion. Paper presented at: the 33rd Annual Macula Society Meeting; 2010 Feb 26; Tuscon, AZ.
    1. Rosenfeld PJ, Fung AE, Puliafito CA. Optical coherence tomography findings after an intravitreal injection of bevacizumab (avastin) for macular edema from central vein occlusion. Ophthalmic Surg Lasers Imaging. 2005;36:336–339.
    1. Prager F, Michels S, Kriechbaum K, et al. Intravitreal bevacizumab (Avastin) for macular edema secondary to retinal vein occlusion: 12-month results of a prospective clinical trial. Br J Ophthalmol. 2009;93:452–456.
    1. Campochiaro PA. Safety and efficacy of intravitreal ranibizumab (Lucentis) in patients with macular edema secondary to branch retinal vein occlusion: The BRAVO Study. Paper presented at: Retina Congress; 2009 Oct 4; New York.
    1. Brown DM. Safety and efficacy of intravitreal ranibizumab (Lucentis) in patients with macular edema secondary to central retinal vein occlusion: The CRUISE Study. Paper presented at: Retina Congress; 2009 Oct 4; New York.
    1. Matsumoto Y, Freund KB, Peiretti E, Cooney MJ, Ferrara DC, Yannuzzi LA. Rebound macular edema following bevacizumab (Avastin) therapy for retinal venous occlusive disease. Retina. 2007;27:426–431.

Source: PubMed

3
Tilaa