Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/12/04 22:41:54」(JST)

wiki en

Rubeosis iridis is a medical condition of the iris of the eye in which new abnormal blood vessels (i.e. neovascularization) are found on the surface of the iris.^[1]

Pathophysiology

It is usually associated with disease processes in the retina, which involve the retina becoming starved of oxygen (ischaemic). The ischemic retina releases a variety of factors, the most important of which is VEGF. These factors stimulate the formation of new blood vessels (angiogenesis). Unfortunately, these new vessels do not have the same characteristics as the blood vessels originally formed in the eye. In addition, new blood vessels can form in areas that do not have them. Specifically, new blood vessels can be observed on the iris. In addition to the blood vessels in the iris, they can grow into the angle of the eye. These blood vessels eventually go through a process called fibrosis which closes the normal physiologic anatomy of the angle. The closing of the angle prevents fluid from leaving the eye resulting in an increase in intraocular pressure. This is called neovascular glaucoma.

Treatment

If caught early, the neovascularization can be reversed with prompt pan retinal photocoagulation (PRP), or injection of anti-VEGF medications with subsequent PRP. The injection blocks the direct effect of VEGF and acts more quickly but will wear off in about 6 weeks.^[2] PRP has a slower onset of action but can last permanently. Once the neovascularization has been longstanding, the new vessels recruit fibrous tissue, and as this forms and contracts, the angle can be permanently damaged, and will not respond to treatment. If this occurs, then surgical intervention is required to reduce the pressure (such as a glaucoma drainage implant)

Causes

This condition is often associated with diabetes in advanced proliferative diabetic retinopathy. Other conditions causing rubeosis iridis include central retinal vein occlusion,^[3] ocular ischemic syndrome,^[4] and chronic retinal detachment.

References

^ "rubeosis iridis" at Dorland's Medical Dictionary
^ Davidorf FH, Mouser JG, Derick RJ. "Rapid improvement of rubeosis iridis from a single bevacizumab (Avastin) injection." Retina. 2006 Mar;26(3):354-6. PMID 16508439.
^ Laatikainen L, Blach RK. "Behaviour of the iris vasculature in central retinal vein occlusion: a fluorescein angiographic study of the vascular response of the retina and the iris." Br J Ophthalmol. 1977 Apr;61(4):272-7. PMID 857872.
^ Dhooge M, de Laey JJ. "The ocular ischemic syndrome." Bull Soc Belge Ophtalmol. 1989;231:1-13. PMID 2488440.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 糖尿病性網膜症：分類および臨床的特徴 diabetic retinopathy classification and clinical features
2. 糖尿病性網膜症：予防および治療 diabetic retinopathy prevention and treatment
3. 原発性眼障害関連の網膜血管炎 retinal vasculitis associated with primary ocular disorders
4. 頭蓋照射の遅延合併症 delayed complications of cranial irradiation
5. 網膜芽細胞腫の概要 overview of retinoblastoma

English Journal

[Ocular ischemic syndrome].

Abraham S1, Feucht N, Lohmann CP, Maier M.
Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft.Ophthalmologe.2015 Aug;112(8):679-81. doi: 10.1007/s00347-014-3178-x.
A 76-year-old patient presented with a reduced visual acuity of 0.8. The clinical examination revealed rubeosis iridis and dilated retinal veins. In fluorescein angiography peripheral retinal ischemia could be observed and panretinal laser coagulation was immediately started. A comprehensive interni
PMID 25480566

[Anti-VEGF therapy in the treatment of anterior segment neovascularization secondary to central retinal vein occlusion].

Kabesha TB1, Glacet-Bernard A2, Rostaqui O2, Souied EH2.
Journal français d'ophtalmologie.J Fr Ophtalmol.2015 May;38(5):414-20. doi: 10.1016/j.jfo.2014.11.007. Epub 2015 May 5.
PURPOSE: To evaluate the benefit of anti-VEGF in the treatment of anterior segment neovascularization (ASNV), a severe complication of ischemic central retinal vein occlusion (CRVO).PATIENTS AND METHODS: This is a retrospective case series of consecutive patients with ASNV secondary to CRVO treated
PMID 25956562

Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing Ahmed glaucoma valve implantation: 2-year follow-up.

Arcieri ES1, Paula JS, Jorge R, Barella KA, Arcieri RS, Secches DJ, Costa VP.
Acta ophthalmologica.Acta Ophthalmol.2015 Feb;93(1):e1-6. doi: 10.1111/aos.12493. Epub 2014 Jul 2.
PURPOSE: To evaluate the efficacy and safety of intravitreal bevacizumab (IVB) in eyes with neovascular glaucoma (NVG) undergoing Ahmed glaucoma valve (AGV) implantation.METHODS: This was a multicentre, prospective, randomized clinical trial that enrolled 40 patients with uncontrolled neovascular gl
PMID 24989855

Japanese Journal

虹彩ルベオーシスと前房出血をきたした網膜剥離の1例

福居萌,中泉敦子,佐藤孝樹,石崎英介,南政宏,植木麻理,池田恒彦
眼科手術 = Journal of ophthalmic surgery 24(2), 215-218, 2011-04-30
NAID 10031040343

臨床報告内頸動脈無形成の合併で虹彩ルベオーシスを生じた虹彩角膜内皮症候群の1例

行徳雄二,川路隆博,稲谷大 [他]
眼科 51(8), 1049-1052, 2009-08-00
NAID 40016786470

Related Pictures

Moran CORE | Neovascularization of the Iris (Rubeosis Iridis) Rubeosis iridis or neovascularization of the iris in diabetes Rubeosis Iridis is a condition characterized by the formation of new weaker and Think Different: Rubeosis Iridis Pin on Ocular Pathophysiology Atlas of Ophthalmology