Factors promoting success and influencing complications in laser-induced central vein bypass
| Autor: | Elena Rochtchina, Paul Mitchell, Mark E. Gillies, Lynne A. Smithies, Ian L. McAllister, Ian J. Constable, Mark Daniell, C. A. Harper |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Retinal Vein Visual acuity genetic structures Visual Acuity Cohort Studies Postoperative Complications Central retinal vein occlusion Risk Factors Retinal Vein Occlusion medicine Humans Prospective Studies Fluorescein Angiography Vein Prospective cohort study Intraoperative Complications Macular edema Intraocular Pressure Aged medicine.diagnostic_test business.industry Choroid Anastomosis Surgical Central venous pressure medicine.disease Fluorescein angiography eye diseases Surgery Ophthalmology medicine.anatomical_structure Treatment Outcome Female Lasers Excimer Laser Therapy medicine.symptom business |
| Zdroj: | Ophthalmology. 119(12) |
| ISSN: | 1549-4713 |
| Popis: | Purpose To evaluate the factors influencing the successful creation of a laser-induced chorioretinal venous anastomosis (L-CRA) and those involved in the development of complications. Design Interventional cohort study. Participants Fifty-five patients with a nonischemic central retinal vein occlusion (CRVO) who were randomized to receive an L-CRA from the total of 108 who completed the follow-up period of the Central Vein Bypass Study. Methods Patients who were randomized to L-CRA were followed up for an 18-month period. They were stratified in 2 sets of 2 cohorts: those who did or did not demonstrate an L-CRA and those who did or did not demonstrate neovascular complications at the site of the L-CRA. Subgroup analysis was performed to determine what factors influenced the creation of an L-CRA and the development of complications at each individual laser site. Main Outcome Measures Identification of systemic and local ocular factors associated with increased success rates of L-CRA creation and those involved with an increased risk of neovascular complications. Results Younger age ( P = 0.03), better baseline visual acuity ( P = 0.04), and the absence of hypertension ( P = 0.001) were systemic features associated with an increased chance of demonstrating a successful L-CRA at each site, whereas sex and duration of the CRVO were not. The position of the L-CRA site did not influence the outcome; however, evidence of rupture of the vein wall at the time of the attempt was associated with a higher chance of success ( P = 0.008). Increased risk of neovascularization, which occurred at 12 sites in 10 eyes, was associated with higher central venous pressure before treatment ( P = 0.03), prolonged fluorescein transit time ( P = 0.0001), and the presence of some capillary nonperfusion ( P = 0.01). Conclusions Younger age, better baseline visual acuity, and the absence of hypertension were associated with an improved success rate, as was evidence of rupture of the vein wall. High baseline central venous pressure, prolonged fluorescein transit time, and the presence of any retinal ischemia were associated with a higher incidence of neovascular complications. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references. |
| Databáze: | OpenAIRE |
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