Journal List > J Korean Ophthalmol Soc > v.50(1) > 1008531

Sangwoo, Yunsik, Sangwoo, and Yunsik: Formation of Collateral Vessels and New Vessels in Branch Retinal Vein Occlusion

Abstract

Purpose

To study the development of collateral vessels and new vessels according to the types of branch retinal vein occlusion (BRVO).

Methods

One hundred and nine eyes of 103 patients with branch retinal vein occlusion were divided into 4 groups by anatomical position of blockage site and pattern of neovascularization. fluorescein angiography was used to examine perfusion/ nonperfusion, size of obstruction site, distance between obstruction site and optic disc (or macula). We compared initial visual acuity and final visual acuity.

Results

there was no statistically significant difference between group in size, between the obstruction site and the optic disc, between the obstruction site and macula. Collateral vessels occurred in major vessel obstruction (MVO) and major vessel and macula obstruction (MVMO) more than in macula obstruction (MO) and peripheral vessel obstruction (PV). Collateral vessels occurred 50 eyes in patients with macula edema and new vessels occurred 36 eyes in patients with macula edema. In collateral group, there was higher incidence of collateral vessels in ischemic type compared to nonischemic type and higher incidence of collateral vessels after laser photocoagulation. ischemic group with collateral vessels had better visual acuity prognosis than perfusion group with collateral vessels.

Conclusions

collateral vessels in BRVO have a favorable effect on visual prognosis. If patients with collateral vessels shows ischemic type, macula edema and involvement of first order, early laser photocoagulation is recommended for visual prognosis.

References

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Figure 1.
Classification of retinal branch vein occlusion according to site of blockage; (A) major branch vessel at disc (B) major branch vessel away from disc (including of macula); (C) minor macular only; (D) peripheral not involving the macula.
jkos-50-61f1.tif
Figure 2.
Collateral vessel in Branch retinal vein occlusion.
jkos-50-61f2.tif
Figure 3.
Size of Obstructon site in branch retinal vein occlusion.
jkos-50-61f3.tif
Figure 4.
distance between obstruction site and optic disc (left) and between obstruction site and macula (Right).
jkos-50-61f4.tif
Table 1.
Characteristics of BRVO
Characteristics No. of patients Total or (%)
Male Female
Age (year) 30-39 1 1 2
40-49 10 0 10
50-59 11 20 31
60-69 8 23 31
70-79 6 17 23
80- 2 4 6
Total 38 65 103
Affected eye Right 5 52 (50.5)
Left 4 45 (43.7)
Bilateral 6 (5.8)
Location of BRVO Superotemporal 7 78 (71.6)
Inferotemporal 2 25 (22.9)
Superonasal 5 (4.6)
Inferonasal 1 (0.9)
Affected order First order 7 75 (68.8)
Second order 3 34 (31.2)
Systemic disease Hypertension 4 48 (46.7)
Diabetes mellitus 9 (8.3)
Hypertension+Diabetes mellitu us 6 (5.5)
PSVT 1 (0.9)
No disease 51 (49.5)

PSVT=Paroxysmal supraventricular tachycardia.

Table 2.
Classification of retinal branch vein occlusion
Characteristics Group No. of patients (%)
according to site of blockage Group A 37 (33.9%)
Group B 42 (38.5%)
Group C 13 (11.9%)
Group D§ 17 (15.6%)
Neovascularization Group Ⅰ (collateral vessels only) 44 (40.4%)
Group Ⅱ (new vessels only) 27 (24.8%)
Group Ⅲ (collateral vessels+new vessels) 18 (16.5%)
Group Ⅳ (no neovasularization) 20 (18.3%)

major branch vessel at disc;

major branch vessel away from disc (including of macula);

minor macular;

§ peripheral not involving the macula.

Table 3.
Classification of retinal branch vein occlusion according to Neovascularization
Group Ⅰ Group Ⅱ Group Ⅲ Group Ⅳ§ P value
Obstruction site 1.08±0.14 1.0±0.19 0.281
Obstruction size 4.51±0.38 3.65±0.66 0.153
Macula invasion 0.79±0.17 1.18±0.24 0.209
Non-perfusion (67/109 eyes) 33/67 (49.3%) 18/67 (26.9%) 9/67 (13.4%) 7/67 (10.4%) 0.005
Perfusion (42/109 eyes) 11/42 (26.2%) 9/42 (21.4%) 9/42 (21.4%) 13/42 (31.0%) 0.183
Laser therapy 31/66 (47.0%) 10/66 (15.2%) 14/66 (21.2%) 11/66 (16.6%) 0.014
IVTA 19/58 (32.7%) 19/58 (32.7%) 13/58 (22.5%) 7/58 (12.1%) 0.017

collateral vessels only;

new vessels only;

collateral vessels+new vessels;

§ no neovasularization

Table 4.
Characteristics of collateral vessels and new vessels
Group A (%) Group B (%) Group C (%) Group D§ (%) P value
Collateral 24/37 (64.9%) 28/42 (66.7%) 3/13 (23.1%) 6/17 (35.3%) 0.008
New vessels 9/37 (24.3%) 23/42 (54.8%) 6/13 (46.2%) 9/17 (52.9%) 0.008
Macular edema Macular edema P value
Collateral 50/77 (64.9%) No col llateral 27/77 (35.1%) 0.003
New vessels 36/77 (46.8%) No new vessels 41/77 (53.2%) 0.235
P Perfusion type
Initial visual acuit ty Final visu ual acuity Visual difference P value
Collateral -1.58±0.25 -1.26 6±0.26 0.25±0.05 0.260
New vessels -2.00±0.29 -1.66 6±0.26 0.38±0.04 0.162
No onperfusion type
Initial visual acuit ty Final visu ual acuity Visual difference P value
Collateral -2.45±0.25 -1.01 1±0.16 1.38±0.08 0.000
New vessels -1.72±0.29 -1.22 2±0.34 0.46±0.07 0.067

major branch vessel at disc;

major branch vessel away from disc (including of macula);

minor macular;

§ peripheral not involving the macula.

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