Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Retinal Vein Occlusion A clinical study of electrophysiology, certain prognostic factors and treatment.

Lindberg, Charlotte LU (2006)
Abstract
The influence of the factor V Leiden mutation on the development of neovascular complications in central retinal vein occlusion was studied. The presence of the mutation was found to enhance the risk of developing neovascular complications almost threefold compared to in patients without the mutation.



Optic nerve head swelling, which recently has been presented as an indicator of good prognosis in central retinal vein occlusion, was not found to be of any certain prognostic value in our study, whereas the prognostic value of fluorescein angiography, full field ERG and initial visual acuity in central retinal vein occlusion was confirmed.



Full field electroretinography (ERG) was evaluated as a... (More)
The influence of the factor V Leiden mutation on the development of neovascular complications in central retinal vein occlusion was studied. The presence of the mutation was found to enhance the risk of developing neovascular complications almost threefold compared to in patients without the mutation.



Optic nerve head swelling, which recently has been presented as an indicator of good prognosis in central retinal vein occlusion, was not found to be of any certain prognostic value in our study, whereas the prognostic value of fluorescein angiography, full field ERG and initial visual acuity in central retinal vein occlusion was confirmed.



Full field electroretinography (ERG) was evaluated as a prognostic instrument for neovascular complications in hemi retinal vein occlusion. The cone b-wave implicit time in the 30 Hz-flicker ERG was shown to be of prognostic value.



Multifocal ERG (mfERG) is an objective method for assessing the function in the central retina, but has not been used much in patients with retinal vein occlusion. We performed a pilot case-control study where we found that the mfERG responses in eyes with branch retinal vein occlusion significantly differed from the responses in the control eyes. In a second study we investigated the mfERG responses in correlation to other clinical parameters to try to get a better understanding of the underlying pathophysiology of the mfERG responses. We found that macular ischemia as measured by fluorescein angiography correlated well with reduced amplitudes and prolonged implicit times on the first order kernel in the mfERG. The strongest correlation was between macular ischemia and prolonged implicit time. A trend towards reduced amplitudes in eyes with central retinal thickening was present, but this was not statistically significant.



In a retrospective case series an initial positive effect of vitrectomy for non-ischemic macular oedema in central and hemi retinal vein occlusion was shown. The macular oedema was significantly reduced at 1 and 2 months after surgery, whereas the visual acuity was improved after 1 month but not thereafter. No beneficial effect was seen in the long term. (Less)
Abstract (Swedish)
Popular Abstract in Swedish

Påverkan av faktor V Leiden-mutationen på risk för utveckling av neovaskulära komplikationer efter centralvenstrombos studerades. Hos patienter med mutationen var risken nästan tre gånger högre att utveckla neovaskulära komplikationer än hos patienter utan mutationen.



Synnervssvullnad , som nyligen har presenterats som en indikator på god prognos vid centralvenstrombos, visades inte i vår studie ha något säkert prognostiskt värde, emedan det prognostiska värdet av fluoresceinangiografi, fullfälts ERG och initial synskärpa vid centralvenstrombos bekräftades.



Fullfälts elektroretinografi (ERG) utvärderades som prognostiskt instrument för utvecklingen av... (More)
Popular Abstract in Swedish

Påverkan av faktor V Leiden-mutationen på risk för utveckling av neovaskulära komplikationer efter centralvenstrombos studerades. Hos patienter med mutationen var risken nästan tre gånger högre att utveckla neovaskulära komplikationer än hos patienter utan mutationen.



Synnervssvullnad , som nyligen har presenterats som en indikator på god prognos vid centralvenstrombos, visades inte i vår studie ha något säkert prognostiskt värde, emedan det prognostiska värdet av fluoresceinangiografi, fullfälts ERG och initial synskärpa vid centralvenstrombos bekräftades.



Fullfälts elektroretinografi (ERG) utvärderades som prognostiskt instrument för utvecklingen av neovaskulära komplikationer vid hemitrombos. b-vågens implicittid vid 30Hz-flicker ERG visades ha prognostiskt värde.



Multifokalt ERG (mfERG) är en objektiv metod för att utvärdera funktionen i den centrala delen av näthinnan, men metoden har endast använts i begränsad utsträckning vid retinal trombos. Vi utförde en fall-kontroll-studie där vi kunde visa att svaren vid mfERG signifikant skiljde sig mellan patienter med grenvenstrombos och kontroller. I en uppföljande studie undersökte vi mfERG-svaren i korrelation till andra kliniska parametrar för att försöka förstå den bakomliggande patofysiologin till mfERG-svaren. Vi fann att ischemi i makula, diagnosticerat med fluoresceinangiografi, korrelerade väl till reducerade amplituder och förlängda implicittider i mfERG-svaren. Det starkaste sambandet sågs mellan ischemi och förläng implicittid. Man såg också en tendens till sänkta amplituder vid ökad retinal tjocklek men detta samband var inte statistiskt signifikant.



I en retrospektiv fallserie på vitrektomi för icke-ischemiskt makulaödem vid central- och hemitrombos sågs en initialt god effekt. Makulaödemet var reducerat 1 och 2 månader postoperativt, och även synskärpan var förbättrad efter 1 månad. Långtidsuppföljningen visade dock ingen förändring 12 mån postoperativt jämfört med preoperativt vare sig av makulaödem eller synskärpa. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Professor Sjölie, Anne-Katrin, Department of Ophthalmology, Odense University Hiospital Odense, Denmark
organization
publishing date
type
Thesis
publication status
published
subject
keywords
Ophtalmology, Oftalmologi, multifocal electroretinography vitrectomy, electroretinography, factor V Leiden, retinal vein occlusion, prognostic factors
pages
105 pages
publisher
Lund University (Media-Tryck)
defense location
Segerfalksalen, Wallenberg Neurocenter Sölvegatan 17 Lund Sweden
defense date
2006-03-03 13:00:00
ISBN
91-85481-40-8
language
English
LU publication?
yes
additional info
id
9906ff99-dc70-4a26-b83b-c041e29c5e1b (old id 546255)
date added to LUP
2016-04-01 17:12:10
date last changed
2018-11-21 20:47:28
@phdthesis{9906ff99-dc70-4a26-b83b-c041e29c5e1b,
  abstract     = {The influence of the factor V Leiden mutation on the development of neovascular complications in central retinal vein occlusion was studied. The presence of the mutation was found to enhance the risk of developing neovascular complications almost threefold compared to in patients without the mutation.<br/><br>
<br/><br>
Optic nerve head swelling, which recently has been presented as an indicator of good prognosis in central retinal vein occlusion, was not found to be of any certain prognostic value in our study, whereas the prognostic value of fluorescein angiography, full field ERG and initial visual acuity in central retinal vein occlusion was confirmed.<br/><br>
<br/><br>
Full field electroretinography (ERG) was evaluated as a prognostic instrument for neovascular complications in hemi retinal vein occlusion. The cone b-wave implicit time in the 30 Hz-flicker ERG was shown to be of prognostic value.<br/><br>
<br/><br>
Multifocal ERG (mfERG) is an objective method for assessing the function in the central retina, but has not been used much in patients with retinal vein occlusion. We performed a pilot case-control study where we found that the mfERG responses in eyes with branch retinal vein occlusion significantly differed from the responses in the control eyes. In a second study we investigated the mfERG responses in correlation to other clinical parameters to try to get a better understanding of the underlying pathophysiology of the mfERG responses. We found that macular ischemia as measured by fluorescein angiography correlated well with reduced amplitudes and prolonged implicit times on the first order kernel in the mfERG. The strongest correlation was between macular ischemia and prolonged implicit time. A trend towards reduced amplitudes in eyes with central retinal thickening was present, but this was not statistically significant.<br/><br>
<br/><br>
In a retrospective case series an initial positive effect of vitrectomy for non-ischemic macular oedema in central and hemi retinal vein occlusion was shown. The macular oedema was significantly reduced at 1 and 2 months after surgery, whereas the visual acuity was improved after 1 month but not thereafter. No beneficial effect was seen in the long term.},
  author       = {Lindberg, Charlotte},
  isbn         = {91-85481-40-8},
  language     = {eng},
  publisher    = {Lund University (Media-Tryck)},
  school       = {Lund University},
  title        = {Retinal Vein Occlusion A clinical study of electrophysiology, certain prognostic factors and treatment.},
  year         = {2006},
}