網膜静脈閉塞症
WordNet
- make a veinlike pattern
- any of the vascular bundles or ribs that form the branching framework of conducting and supporting tissues in a leaf or other plant organ (同)nervure
- one of the horny ribs that stiffen and support the wing of an insect (同)nervure
- a layer of ore between layers of rock (同)mineral vein
- a blood vessel that carries blood from the capillaries toward the heart; "all veins except the pulmonary vein carry unaerated blood" (同)vena, venous blood vessel
- a distinctive style or manner; "he continued in this vein for several minutes"
- closure or blockage (as of a blood vessel)
- (dentistry) the normal spatial relation of the teeth when the jaws are closed
- in or relating to the retina of the eye; "retinal cells"
- the innermost light-sensitive membrane covering the back wall of the eyeball; it is continuous with the optic nerve
- having or showing markings that resemble veins (同)venose, veinlike
PrepTutorEJDIC
- 〈C〉『静脈』 / 〈C〉(植物の)葉脈;(昆虫の)翅脈;(石の)石理;(木の)木目 / 〈C〉岩脈,鉱脈 / 〈U〉《しばしば a vein》(…の)傾向,性質《+of+名》 / 〈U〉《the vein》(…に対する)気分,気持ち《+for+名(doing)》
- (目の)網膜
- しも(筋)のある,筋のついた
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2016/01/04 13:08:19」(JST)
[Wiki en表示]
Central retinal vein occlusion |
Diagram of the eye; retinal vein is number 21.
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Classification and external resources |
Specialty |
ophthalmology |
ICD-10 |
H34.8 |
ICD-9-CM |
362.35 |
DiseasesDB |
11421 |
MedlinePlus |
007330 |
eMedicine |
article/798583 |
MeSH |
D012170 |
The central retinal vein is the venous equivalent of the central retinal artery and, like that blood vessel, it can suffer from occlusion (central retinal vein occlusion, also CRVO[1]), similar to that seen in ocular ischemic syndrome. Since the central retinal artery and vein are the sole source of blood supply and drainage for the retina, such occlusion can lead to severe damage to the retina and blindness, due to ischemia (restriction in blood supply) and edema (swelling).[2]
It can also cause glaucoma.
Nonischemic CRVO is the milder form of the disease. It may progress to the more severe ischemic type.[3]
Treatment
Treatment consists of Anti-VEGF drugs like Lucentis or intravitreal steroid implant (Ozurdex) and Pan-Retinal Laser Photocoagulation usually. Underlying conditions also require treatment. Non-Ischemic CRVO has better visual prognosis than Ischemic CRVO.
A systematic review studied the effectiveness of the anti-VEGF drugs ranibizumab and pagatanib sodium for patients suffering from non-ischemic CRVO.[4] Though there was a limited sample size, participants in both treatment groups showed improved visual acuity over 6 month periods, with no safety concerns.[4]
See also
- Macular edema
- Ischemic optic neuropathy
- Branch retinal vein occlusion
- Lucentis
- Iridodialysis
References
- ^ Ophthalmology at a Glance, Jane Olver & Lorraine Cassidy, Blackwell Science 2005.[page needed]
- ^ Hayreh, Sohan Singh; Zimmerman, M. Bridget; Podhajsky, Patricia (1994). "Incidence of Various Types of Retinal Vein Occlusion and Their Recurrence and Demographic Characteristics". American Journal of Ophthalmology 117 (4): 429–41. doi:10.1016/S0002-9394(14)70001-7. PMID 8154523.
- ^ Central Retinal Vein Occlusion at eMedicine
- ^ a b Braithwaite T, Nanji AA, Lindsley K, Greenberg PB (2014). "Anti-vascular endothelial growth factor for macular oedema secondary to central retinal vein occlusion". Cochrane Database Syst Rev 5: CD007325. doi:10.1002/14651858.CD007325.pub3. PMID 24788977.
UpToDate Contents
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English Journal
- Results of intravitreal triamcinolone acetonide in patients with macular edema secondary to branch retinal vein occlusion.
- Demir M, Oba E, Guven D, Acar Z, Cinar S.Author information Department of Ophthalmology, Sisli Etfal Training and Research Hospital, Halaskargazi caddesi Etfal sokak, Etfal Hastanesi, 34400, Istanbul, Turkey, drmehmetfe@hotmail.com.AbstractBackground Macular edema is one of the most common causes of visual loss in patients with retinal vein oclusions. Intravitreal corticosteroids and intravitreal anti-vascular endothelial growth factors are modalities of treatment for macular edema secondary to branch retinal vein occlusion (BRVO). Objective To present the results of intravitreal triamcinolone acetonide therapy in patients with macular edema secondary to BRVO. Setting A retrospective clinical interventional study included 32 patients with macular edema secondary to BRVO. Method The records of 32 eyes of 32 patients who received 4 mg/0.1 mL injection of intravitreal triamcinlone for macular edema secondary to BRVO were evaluated. Patients with visual acuity <0.40 logMAR (logarithm of the minimum angle of resolution), central macular thickness (CMT) >260 μm and no neovascularization at baseline were included. Patients with diabetes mellitus, a history of intravitreal anti vascular endothelial growth factor injection, grid laser photocoagulation and ischemic BRVO were excluded. The re-injections were performed in cases with increased CMT >100 μm or vision loss of five or more letters. Results The mean follow-up was 12 ± 1.9 months. The visual acuity increased from 0.58 ± 0.16 at baseline to 0.25 ± 0.11 logMAR (P < 0.001). The CMT decreased from 490 ± 107 μm at baseline to 266 ± 90 μm at 12 months (P < 0.001). Both cataract and glaucoma developed in 18.75 % patients. Conclusion Intravitreal triamcinolone, due to absence of systemic side effects, can be used with confidence for treatment macular edema secondary to BRVO. However the main disadvantages of intravitreal triamcinolone injection are elevation of intraocular pressure and formation of cataract.
- International journal of clinical pharmacy.Int J Clin Pharm.2014 Feb 9. [Epub ahead of print]
- Background Macular edema is one of the most common causes of visual loss in patients with retinal vein oclusions. Intravitreal corticosteroids and intravitreal anti-vascular endothelial growth factors are modalities of treatment for macular edema secondary to branch retinal vein occlusion (BRVO). Ob
- PMID 24510511
- Level of Vascular Endothelial Growth Factor 165b in Human Aqueous Humor.
- Baba T, Bikbova G, Kitahashi M, Yokouchi H, Oshitari T, Yamamoto S.Author information Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine , Chiba , Japan.AbstractAbstract Purpose: Vascular endothelial growth factor 165b (VEGF165b) is a splice variant of VEGF-A and is an anti-angiogenic form as opposed to a pro-angiogenic form of VEGF. We compared the level of VEGF165b in the aqueous humor of 77 eyes with exudative age-related macular degeneration (AMD) and 38 eyes with retinal vein occlusion (RVO). Design: A prospective, interventional case series. Methods: The concentration of aqueous VEGF165b was measured by enzyme-linked immunosorbent assay (ELISA), and its level in the subgroups of AMD, classic and occult choroidal neovascularization (CNV) and polypoidal choroidal vasculopathy (PCV), was compared. The relationships between the VEGF165b level and the greatest linear dimension (GLD), central foveal thickness (CFT), and the height of the subretinal fluid (SRF) were determined for the AMD and RVO cases. Results: The level of VEGF165b was higher than the lower limit of detection (15 pg/ml) in 57% of the AMD cases (median, 16.4; range, <15-98 pg/ml) and 63% of the controls (median, 20.6; range, <15-46 pg/ml). The percentage of eyes with >15 pg/ml of VEGF165b was significantly lower in eyes with RVO (32%, p = 0.038). The VEGF165b level was not significantly different among the AMD subtypes, and it was not significantly correlated with the GLD, CFT, and SRF. In the RVO cases, the CFT and SRF thickness were greater in eyes with a VEGF level <15 pg/ml (p = 0.006, 0.048 respectively). Conclusions: The anti-angiogenic VEGF165b was low in eyes with RVO. Therapy based on balancing the pro- and anti-angiogenic factors might be a new approach to treat ocular vascular disorders.
- Current eye research.Curr Eye Res.2014 Feb 6. [Epub ahead of print]
- Abstract Purpose: Vascular endothelial growth factor 165b (VEGF165b) is a splice variant of VEGF-A and is an anti-angiogenic form as opposed to a pro-angiogenic form of VEGF. We compared the level of VEGF165b in the aqueous humor of 77 eyes with exudative age-related macular degeneration (AMD) and 3
- PMID 24502617
- Presence of foveal bulge in optical coherence tomographic images in eyes with macular edema associated with branch retinal vein occlusion.
- Hasegawa T1, Ueda T2, Okamoto M2, Ogata N2.Author information 1Department of Ophthalmology, Nara Medical University, Nara, Japan. Electronic address: taijiha@naramed-u.ac.jp.2Department of Ophthalmology, Nara Medical University, Nara, Japan.AbstractPURPOSE: To determine whether a significant correlation exists between the presence of a bulge in the photoreceptor inner segment/outer segment (IS/OS) line and the best-corrected visual acuity (BCVA) in eyes with resolved macular edema associated with branch retinal vein occlusion (BRVO).
- American journal of ophthalmology.Am J Ophthalmol.2014 Feb;157(2):390-396.e1. doi: 10.1016/j.ajo.2013.10.007. Epub 2013 Oct 19.
- PURPOSE: To determine whether a significant correlation exists between the presence of a bulge in the photoreceptor inner segment/outer segment (IS/OS) line and the best-corrected visual acuity (BCVA) in eyes with resolved macular edema associated with branch retinal vein occlusion (BRVO).DESIGN: Re
- PMID 24439442
Japanese Journal
- Enhanced Depth Imaging Optical Coherence Tomography of the Choroid in Central Retinal Vein Occlusion
- Tsuiki Eiko,Suzuma Kiyoshi,Ueki Ryotaro,Maekawa Yuki,Kitaoka Takashi
- American Journal of Ophthalmology 156(3), 543-547, 2013-09
- … Purpose: To evaluate subfoveal choroidal thickness in patients with central retinal vein occlusion (CRVO) using enhanced depth imaging optical coherence tomography. …
- NAID 120005328275
- 臨床報告 骨粗鬆症治療薬バゼドキシフェン酢酸塩(ビビアント)の副作用と考えられた網膜中心静脈閉塞症の1例
- 網膜中心静脈閉塞症の黄斑浮腫に対するベバシズマブ硝子体注射の長期予後にかかわる因子 (特集 第66回日本臨床眼科学会講演集(5))
Related Links
- Retinal vein occlusion (RVO) is an important cause of visual loss among older adults throughout the world. RVO is the second most common cause of vision loss from retinal vascular disease, following diabetic retinopathy. Despite ...
- Retinal Vein Occlusion. Retinal vein occlusion (RVO) is a common vascular disorder of the retina and one of the most common causes of vision loss worldwide. ... Francisco Talavera, PharmD, PhD Adjunct Assistant ...
Related Pictures
★リンクテーブル★
[★]
- 英
- 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
比較
- SOP.134
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網膜静脈分枝閉塞症
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網膜中心静脈閉塞症
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網膜中心動脈閉塞症
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BRVO
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CRVO
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CRAO
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概念
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網膜動静脈交差部で静脈が閉鎖
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網膜中心静脈の閉塞
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網膜中心動脈の閉塞
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疫学
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CRVOより遙かに頻度が高い
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50歳以上の中高年で高血圧症のある人に好発
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(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
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病型
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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
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症状
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黄斑部を支配する静脈が閉塞すれば視力低下を痔核。
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無痛性の片眼性の急激な視力低下
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無痛性の高度視力障害
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眼底
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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。
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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
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網膜は混濁、白濁。cherry-red spot
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合併症
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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)。
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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。
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治療
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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
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原疾患の治療 新生血管緑内障予防:汎光凝固術
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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
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予後
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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。
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参考
- 1. [charged] Retinal vein occlusion: Epidemiology, clinical manifestations, and diagnosis - uptodate [1]
[★]
網膜静脈血栓症
- 関
- retinal vein occlusion
[★]
網膜中心静脈閉塞症, CRVO
[★]
網膜静脈分枝閉塞症 BRVO
[★]
- 関
- occlude
- 関
- atresia、close、closure、dental articulation、disturb、disturbance、hamper、hindrance、impede、impediment、intercept、interception、interfere、interrupt、interruption、obliteration、obstruct、obstruction、occlude、preclusion
[★]
- 関
- 11-cis-retinal、retina、retinae、retinaldehyde, retinol
[★]
網膜静脈
- 関
- central retinal vein
[★]
静脈