[Retinal vein occlusion management algorithm. Part 3. Neovascular complications].

Autor: Budzinskaya MV; Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021., Mazurina NK; Posterior segment eye surgery and diagnostics center LLC, 2-aya Vladimirskaya St., Moscow, Russian Federation, 111123., Egorov AE; Pirogov Russian National Research Medical University, 1 Ostrovityanova St., Moscow, Russian Federation 117997., Kuroedov AV; Pirogov Russian National Research Medical University, 1 Ostrovityanova St., Moscow, Russian Federation 117997; Mandryka Clinical Research and Training Medical Center, 8A Bol'shaya Olen'ya St., Moscow, Russian Federation, 107014., Loskutov IA; Scientific Clinical Center of JSC Russian Railways, 20 Chasovaya St., Russian Federation, 125315., Plyukhova AA; 'SovMedTeh' LLC, Eximer clinic, 3-1 Marksistskaya St., Moscow, Russian Federation, 109147., Razik S; Medical diagnostic center 'Olimp' LLC, 77 Udal'tsova St., Moscow, Russian Federation, 119454., Ryabtseva AA; Moscow Regional Research and Clinical Institute named after M.F. Vladimirskiy, 61/2 Shchepkina St., Moscow, Russian Federation, 129110., Simonova SV; S.P. Botkin State Clinical Hospital, Branch #1, Moscow Department of Public Health, 7 Mamonovskiy pereulok, Moscow, Russian Federation, 123001.
Jazyk: ruština
Zdroj: Vestnik oftalmologii [Vestn Oftalmol] 2015 Nov-Dec; Vol. 131 (6), pp. 67-75.
DOI: 10.17116/oftalma2015131667-75
Abstrakt: Neovascular complications severity in central/branch retinal vein occlusion (RVO) correlates with the level of occlusion and the degree of retinal perfusion disturbance. Large areas of retinal non-perfusion (more than half of the total retinal area) are associated with the risk for posterior segment neovascularization as high as 33% and for neovascular glaucoma - 45%. Over the past 30 years there has been an evident declining tendency of neovascular complications rates in the natural course of RVO. In ischemic RVO, anterior segment neovascularization is more aggressive than posterior. Neovascular glaucoma usually develops within the first 6 months of disease and correlates with uncontrolled arterial hypertension. Panretinal photocoagulation (PRP) is a standard treatment for anterior and posterior segment neovascularization in RVO patients. Anti-VEGF agents, if used as monotherapy, lead to rapid, however, short-term remission. Combination therapy, that is anti-VEGF injections and PRP, is the most effective. Intravitreal steroids have demonstrated no effect on ocular neovascularization. If PRP cannot be performed and intraocular pressure levels remain high, one should consider glaucoma drainage implant surgery. Preventive measures for neovascular complications that have proved effective so far include regular follow-ups, individually scheduled intravitreal injections, and PRP for large zones of ischemia.
Databáze: MEDLINE