scholarly journals Long-Term Follow-Up Case of Multiple Retinal Arterial Macroaneurysms Developing Branch Retinal Vein Occlusion following Ruptured Macroaneurysm

2016 ◽  
Vol 7 (1) ◽  
pp. 243-248 ◽  
Author(s):  
Yuya Terubayashi ◽  
Teruyo Kida ◽  
Masanori Fukumoto ◽  
Jun Sugasawa ◽  
Seita Morishita ◽  
...  

Purpose: Retinal arterial macroaneurysm (RAM) has been reported in association with branch retinal vein occlusion (BRVO), and usually BRVO precedes RAM. We present a long-term follow-up case report of unilateral multiple RAMs that developed BRVO following ruptured RAM in the same retinal quadrant. Case Presentation: An 80-year-old woman presented with floaters in her right eye in June 2012. Visual acuity (VA) was 20/25 in her right eye with posterior capsular opacity. Her fundus showed the first ruptured RAM at the superotemporal vascular arcade with subinternal limiting membrane and subretinal hemorrhages not involving the macula. These were absorbed gradually with a VA of 20/20. After 2 years, the second RAM at the proximal superotemporal vascular arcade developed and impending BRVO occurred with macular edema at the distal site of the RAM. With the RAM located close to the arteriovenous crossing, her VA was dropped to 20/60. Intravitreal injection of ranibizumab was performed and macular edema was resolved with improved vision of 20/30. Three months later, she realized a sudden vision loss of 2/200. Her posterior pole showed massive pre- and subretinal hemorrhages, and vitrectomy was performed. The source of bleeding was the third RAM’s rupture in a different artery. Her vision improved to 20/30. The unaffected eye showed no RAMs. Conclusion: We experienced a long-term follow-up case of multiple RAMs showing different courses. We should cautiously note that BRVO can occur following RAM at the arteriovenous crossing.

2009 ◽  
Vol 247 (12) ◽  
pp. 1635-1641 ◽  
Author(s):  
Alexandra E. Hoeh ◽  
Thomas Ach ◽  
Karen B. Schaal ◽  
Alexander F. Scheuerle ◽  
Stefan Dithmar

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoshimi Sugiura ◽  
Fumiki Okamoto ◽  
Tomoya Murakami ◽  
Shohei Morikawa ◽  
Takahiro Hiraoka ◽  
...  

AbstractTo evaluate the effects of intravitreal ranibizumab injection (IVR) on metamorphopsia in patients with branch retinal vein occlusion (BRVO), and to assess the relationship between metamorphopsia and inner retinal microstructure and other factors. Thirty-three treatment-naïve eyes of 33 patients with macular edema caused by BRVO with at least 12 months of follow-up were included. The degree of metamorphopsia was quantified using the M-CHARTS. Retinal microstructure was assessed with spectral-domain optical coherence tomography. Disorganization of the retinal inner layers (DRIL) at the first month after resolution of the macular edema (early DRIL) and at 12 months after treatment (after DRIL) was studied. Central retinal thickness (CRT), and status of the external limiting membrane as well as ellipsoid zone were also evaluated. IVR treatment significantly improved best-corrected visual acuity (BCVA) and CRT, but the mean metamorphopsia score did not improve even after 12 months. Post-treatment metamorphopsia scores showed a significant correlation with pre-treatment metamorphopsia scores (P < 0.005), the extent of early DRIL (P < 0.05) and after DRIL (P < 0.05), and the number of injections (P < 0.05). Multivariate analysis revealed that the post-treatment mean metamorphopsia score was significantly correlated with the pre-treatment mean metamorphopsia score (P < 0.05). IVR treatment significantly improved BCVA and CRT, but not metamorphopsia. Post-treatment metamorphopsia scores were significantly associated with pre-treatment metamorphopsia scores, the extent of DRIL, and the number of injections. Prognostic factor of metamorphopsia was the degree of pre-treatment metamorphopsia.


Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins

The Ranibizumab for Macular Edema following Branch Retinal Vein Occlusion (BRAVO) study was a 6-month, phase III, randomized, injection-controlled trial, with an additional 6 months of follow-up (total 12 months), to evaluate the safety and efficacy of intraocular injections of 0.3 mg and 0.5 mg ranibizumab (an anti–vascular endothelial growth factor [VEGF] agent) in patients with macular edema following branch retinal vein occlusion (BRVO). The study showed that intraocular injections of 0.3 mg or 0.5 mg ranibizumab provided rapid, effective treatment for macular edema following BRVO with low rates of ocular and nonocular adverse events. This study led to a paradigm shift toward anti-VEGF agents as the first-line treatment for macular edema secondary to BRVO.


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