VASCULAR RETINAL VENOUS OBSTRUCTION AND NEOVASCULARISATION
Abstract:
Central retinal vein occlusion (CRVO) represents a major cause of visual loss and the second-most common retinal vascular disorder. Branch retinal vein occlusion (BRVO) is a common, visually disabling disease and consists of two distinct clinical entities: major BRVO and macular BRVO. A variety of neovascular events can appear in eyes with CRVO and BRVO, these are iris neovascularisation, angle neovascularisation, disc neovascularisation, neovascular glaucoma (NVG) and vitreous hemorrhage. The vascular endothelial growth factor (VEGF) plays a major role in the development of neovascularisation in eyes with CRVO and BRVO. The aim of this study is to characterize neovascular events that can occur in eyes with CRVO or BRVO. We took in the study a total number of 110 eyes from patients hospitalized in the Clinical County Emergency Hospital of Sibiu for a period of 7 years (December 2010-December 2016), 75% eyes presented CRVO and 25% eyes with BRVO. From a total of 110 eyes with CRVO and BRVO, 15% presented at the time they were hospitalized poor vision, high intraocular pressure (IOP), optic disc neovascularisation and vitreous hemorrhage. The first attitude was to stop the neovascularization by administrating intravitreal anti-VEGF factor and later, photocoagulation of the retina. From hospitalized cases, 20% developed neovascular glaucoma and presented high IOP, so we used a treatment plan that can help us to keep the IOP to normal values and in cases that were refractory to treatment, we performed trabeculectomy. Clinical monitoring of vascular venous obstruction by ophthalmoscopy and OCT imaging brings into attention the neovascularisation appearance and NVG. Intravitreal administration of anti-VEGF agents is an option to stop the neovascularisation, much better in combination with photocoagulation
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