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Pathophysiologic mechanisms based treatment for RVO related macular edema
Author(s) -
POURNARAS C
Publication year - 2014
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2014.1711.x
Subject(s) - pathophysiology , medicine , edema , macular edema , ophthalmology , surgery , pathology , visual acuity
The retinal vein occlusion (RVO) related to visual loss, results from changes in the blood‐retina barrier leading to the formation of an extracellular retinal edema; and conconmmitant arteriolar vasoconstruction, leading to tissue hypoxia, intracellular retinal edema and neuronal cell death. Patient’s evaluation requires the definition of the pathogenic role of systemic diseases affecting the retinal vessels wall. In addition, hemodynamic modifications of the retinal blood flow and primary and secondary thrombophilias, may trigger the manifestation of the RVO occlusive event. Current treatment of acute RVO aims to restore venous circulation. In that sense, isovolemic hemodilution leads to an increase of ocular blood flow and regression of tissue hypoxia. Grid macular photocoagulation, reversing the inner retinal tissue hypoxia, improves visual prognosis in eyes with macular edema following branch RVO. The intra‐vitreal treatments using anti‐VEGF and anti‐inflammatory drugs, reverse the veins abnormal permeability, relieve the macular edema, either in branch or central RVO, offering new insights for the management of those pathologies.