BRVO

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網膜静脈分枝閉塞症

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英文文献

  • Changes in aqueous cytokines after intravitreal triamcinolone versus bevacizumab for macular oedema in branch retinal vein occlusion.
  • Sohn HJ1, Han DH, Lee DY, Nam DH.Author information 1Department of Ophthalmology, Hongik Hospital, Seoul, KoreaDepartment of Ophthalmology, Gachon University Gil Hospital, Incheon, Korea.AbstractPurpose:  To investigate the changes in the aqueous levels of various cytokines after intravitreal triamcinolone or bevacizumab for branch retinal vein occlusion (BRVO). Methods:  Twenty-four eyes with macular oedema associated with BRVO and six eyes of six patients undergoing cataract surgery participated in this study. Each patient with BRVO randomly received an intravitreal injection of either 4 mg triamcinolone or 1.25 mg bevacizumab. Aqueous samples were obtained before and 4 weeks after the intravitreal injection in the BRVO group and before surgery in the control group. Aqueous concentrations of 16 cytokines were measured via multiplex bead assay. Results:  Prior to the administration of the drugs, aqueous levels of interleukin (IL)-6, IL-8, IL-17 and vascular endothelial growth factor (VEGF) were significantly higher in the BRVO group than in the control group (p = 0.044, p = 0.013, p < 0.001, and p = 0.008, respectively). Between the control group and the BRVO group, no significant differences were noted between pre- and postinjection best-corrected visual acuity (p = 0.60, p = 0.54) and central foveal thickness (p = 0.47, p = 0.82). In the triamcinolone group, levels of IL-6, IL-17, IP-10, platelet-derived growth factor (PDGF)-AA and VEGF were reduced significantly (p = 0.012, p < 0.001, p < 0.001, p = 0.015, and p < 0.001, respectively). But in bevacizumab group, only VEGF was significantly reduced (p < 0.001). Between the IVTA group and the IVBe group, no significant differences in the changes in VEGF levels were noted (p = 0.06). Conclusion:  Triamcinolone injection reduces plural inflammatory cytokines in BRVO, while bevacizumab has no influence on other cytokines as selective anti-VEGF therapy. No differences in the therapeutic effect were noted between an inhibition of plural inflammatory cytokines and an inhibition of VEGF only.
  • Acta ophthalmologica.Acta Ophthalmol.2014 May;92(3):e217-24. doi: 10.1111/aos.12219. Epub 2013 Jul 26.
  • Purpose:  To investigate the changes in the aqueous levels of various cytokines after intravitreal triamcinolone or bevacizumab for branch retinal vein occlusion (BRVO). Methods:  Twenty-four eyes with macular oedema associated with BRVO and six eyes of six patients undergoing cataract surgery p
  • PMID 23889803
  • Electroretinograms and level of aqueous vascular endothelial growth factor in eyes with hemicentral retinal vein occlusion or branch retinal vein occlusion.
  • Yasuda S1, Kachi S, Ueno S, Ushida H, Piao CH, Kondo M, Terasaki H.Author information 1Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan.AbstractPURPOSE: Hemicentral retinal vein occlusion (hCRVO) is a disease related to CRVO but not to branch retinal vein occlusion (BRVO). We reported a significant correlation between aqueous vascular endothelial growth factor (VEGF) levels and the implicit time of 30-Hz flicker electroretinogram (ERG) in CRVO eyes. The purpose of this study was to compare aqueous VEGF levels and ERG components between hCRVO and BRVO eyes.
  • Japanese journal of ophthalmology.Jpn J Ophthalmol.2014 May;58(3):232-236. Epub 2014 Mar 26.
  • PURPOSE: Hemicentral retinal vein occlusion (hCRVO) is a disease related to CRVO but not to branch retinal vein occlusion (BRVO). We reported a significant correlation between aqueous vascular endothelial growth factor (VEGF) levels and the implicit time of 30-Hz flicker electroretinogram (ERG) in C
  • PMID 24668132
  • A United Kingdom-based economic evaluation of ranibizumab for patients with retinal vein occlusion (RVO).
  • Taylor M1, Serbetci E, Ferreira A, Gairy K, Lewis L, Blouin J, Mitchell P.Author information 1York Health Economics Consortium Ltd, University of York , York , UK.AbstractAbstract Objective: This study compares the cost-effectiveness of intravitreal ranibizumab vs observation and/or laser photocoagulation for treatment of macular edema secondary to retinal vein occlusion in a UK-based model. Methods: A Markov model was constructed using transition probabilities and frequency of adverse events derived using data from the BRAVO, CRUISE, and HORIZON trials. Outcomes associated with treatments and health states were combined to predict overall health costs and outcomes for cohorts treated with each option. Results: In branch retinal vein occlusion, ranibizumab produced a gain of 0.518 quality-adjusted life years at an incremental cost of £8141, compared with laser photocoagulation. The incremental cost-effectiveness ratio was £15,710 per quality-adjusted life year, and the incremental cost per month free from blindness was £658. In central retinal vein occlusion, ranibizumab produced a gain of 0.539 quality-adjusted life years at an incremental cost of £9216, compared with observation only. The incremental cost-effectiveness ratio was £17,103, and the incremental cost per month free from blindness was £423. Conclusions: These incremental cost-effectiveness ratios are below the £20,000-30,000 range typically accepted as a threshold for cost-effectiveness. This suggests that ranibizumab may be regarded as a cost-effective therapy for patients with macular edema secondary to retinal vein occlusion, relative to grid laser photocoagulation (for BRVO) and observation (for CRVO). Limitations include sparse data for utilities associated with the severity of visual impairment in the WSE in patients with RVO. A lack of direct comparative evidence between ranibizumab and the dexamethasone intravitreal implant for the treatment of BRVO and CRVO and the infeasibility of an indirect comparison due to significant heterogeneity in trial designs prevented the inclusion of this treatment as a comparator in the Markov model.
  • Journal of medical economics.J Med Econ.2014 Apr 22. [Epub ahead of print]
  • Abstract Objective: This study compares the cost-effectiveness of intravitreal ranibizumab vs observation and/or laser photocoagulation for treatment of macular edema secondary to retinal vein occlusion in a UK-based model. Methods: A Markov model was constructed using transition probabilities and f
  • PMID 24673384

和文文献

  • BRVO,CRVOのマネージメント (特集 網膜血管病の病態とマネージメント)
  • Grid photocoagulation combined with intravitreal bevacizumab for recurrent macular edema associated with retinal vein occlusion.
  • Ogino Ken,Tsujikawa Akitaka,Murakami Tomoaki,Muraoka Yuki,Kurashige Yumiko,Yoshimura Nagahisa
  • Clinical ophthalmology (Auckland, N.Z.) 5, 1031-1036, 2011-07
  • … Methods: This retrospective study consisted of 19 eyes with branch retinal vein occlusion (BRVO) and nine eyes with central retinal vein occlusion (CRVO), which were treated with grid photocoagulation combined with IVB for recurrent macular edema after previous IVBs. … Compared with initial values, final foveal thickness was reduced significantly in both BRVO and CRVO groups (P < … 0.001), but improvement in VA was significant only for eyes with BRVO (P = 0.012). …
  • NAID 120003338838

関連リンク

2006年11月2日 ... 網膜静脈分枝閉塞症(BRVO)について-. 【概論】 網膜静脈分枝閉塞症 branch retinal vein occlusion,BRVOとは、網膜静脈の分岐が閉塞を来たし、網膜に出血を来たす 疾患である。上耳側静脈域に好発する。網膜中心静脈閉塞症より頻度 ...

関連画像

Branched Retinal Vein Occlusion (BRVO)Retinal Vascular DiseasesDescription Branch retinal vein occlusion BRVOrelatively common cause of ret. vascular brvo cf


★リンクテーブル★
リンク元網膜静脈閉塞症」「網膜静脈分枝閉塞症」「branch retinal vein occlusion
関連記事BR

網膜静脈閉塞症」

  [★]

retinal vein occlusion, obstruction of the retinal vein


分類

リスクファクター

参考1
  • 年齢、高血圧、糖尿病、喫煙、肥満、凝固亢進状態(factor V Leiden, activated protein C resistance)、緑内障、網膜細血管異常(retinal arteriolar abnormality)
出典不明
  • 動脈硬化

比較

SOP.134
  網膜静脈分枝閉塞症 網膜中心静脈閉塞症 網膜中心動脈閉塞症
BRVO CRVO CRAO
概念 網膜動静脈交差部で静脈が閉鎖 網膜中心静脈の閉塞 網膜中心動脈の閉塞
疫学 CRVOより遙かに頻度が高い 50歳以上の中高年で高血圧症のある人に好発 (1)血栓塞栓子、(2)乳頭内での粥状硬化、あるいは動脈炎による血管攣縮による動脈の閉塞、(3)緑内障や外力による高眼圧
病型   静脈うっ滞網膜症 venous stasis retinopathy:静脈拡張、出血など静脈閉塞のみを主症状とする。
出血性網膜症 hemorrhagic retinopathy:高度の血管床閉塞など動脈の循環障害を併発
 
症状 黄斑部を支配する静脈が閉塞すれば視力低下を痔核。 無痛性の片眼性の急激な視力低下 無痛性の高度視力障害
眼底 閉塞した静脈域で静脈の拡張し、透過性亢進による出血、浮腫、綿花白斑を生じる。数ヶ月の経過で出血は吸収され、静脈は白線化し、硬性白斑が残る。 視神経乳頭から放射状の火炎状出血、(重症例)暗赤色の出血斑。乳頭の充血、浮腫、網膜静脈の拡張蛇行、綿花様白斑、黄斑浮腫から嚢胞様黄斑浮腫 網膜は混濁、白濁。cherry-red spot
合併症 新生血管形成と硝子体出血。再発性硝子体出血と牽引性網膜剥離症(閉塞した静脈域の毛細血管の閉塞によりその領域周辺の網膜や視神経乳頭での血管新生をきたす)。 新生血管緑内障:予後不良。発症から3ヶ月が好発時期。前房隅角や虹彩に新生血管が生じ眼圧上昇をきたす。  
治療 光凝固術:黄斑浮腫、新生血管に対して。
硝子体手術:硝子体手術、牽引性網膜剥離
原疾患の治療
新生血管緑内障予防:汎光凝固術
眼球圧迫マッサージ
亜硝酸アミル
(高眼圧の場合)前房穿刺
予後     1時間以内に血行が改善しないと網膜機能の回復は期待できない。

参考

  • 1. [charged] Retinal vein occlusion: Epidemiology, clinical manifestations, and diagnosis - uptodate [1]


網膜静脈分枝閉塞症」

  [★]

branch retinal vein occlusion BRVO
網膜静脈閉塞症網膜静脈分枝閉塞

概念

  • 網膜動静脈交差部で静脈が閉鎖

疫学

症状

  • 黄斑部を支配する静脈が閉塞すれば視力低下を痔核。

検査

  • 眼底検査:閉塞した静脈域で静脈の拡張し、透過性亢進による出血、浮腫、綿花白斑を生じる。数ヶ月の経過で出血は吸収され、静脈は白線化し、硬性白斑が残る。

合併症

  • 新生血管形成と硝子体出血。再発性硝子体出血と牽引性網膜剥離症(閉塞した静脈域の毛細血管の閉塞によりその領域周辺の網膜や視神経乳頭での血管新生をきたす)。

治療

  • 光凝固術:黄斑浮腫、新生血管に対して。
  • 硝子体手術:硝子体手術、牽引性網膜剥離



branch retinal vein occlusion」

  [★] 網膜静脈分枝閉塞症 BRVO


BR」

  [★]


"http://meddic.jp/BRVO" より作成


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