Retinal vein occlusion and its complications are among the most common causes of severe loss of sight in developed countries. In recent years, developments in imaging methods have been introduced, leading to an improvement in diagnostic possibilities. At the same time new treatment options have become available (new intravitreal drugs and treatment protocols, laser and surgical methods). The presented guidelines summarize the current knowledge about retinal vein occlusion in order to standardize and update procedures for the diagnosis, classification and treatment of the disease.

• Keywords
• diagnosis, diagnostics, guidelines, retinal vein occlusion, treatment, type 2 diabetes,
• MeSH
• Humans MeSH
• Retinal Vein Occlusion * diagnosis   therapy   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Practice Guideline MeSH

Although temporal branch retinal vein occlusion has, on the whole, a good prognosis, in about 40% of the patients the outcoming vision is markedly changed. The authors used argon laser to treat 15 patients suffering from temporal branch retinal vein occlusion. They analyze their experiences and the results of the treatment of chronic macular edema and neovascularizations with argon laser photocoagulation. In 5 of 7 patients with chronic macular edema, they achieved resorption of the edema within 2 months after photocoagulation. They elaborated their own modification of the laser barrage according to L'Esperance. In more than half the patients, treated for chronic macular edema, the achieved visual acuity was 6/6-6/9, the worst vision was 6/18. In none of the patients a decrease in visual acuity occurred. In the management of neovascularizations of the retina and the disc of the optic nerve, argon laser photocoagulation resulted in involution of the neovascularizations in all 3 patients, vitreous hemorrhage did not occur in any of the eyes. Although the group of the treated patients is only small, the authors consider the treatment of the temporal branch retinal vein occlusion with argon laser photocoagulation to be beneficial.

• MeSH
• Argon therapeutic use   MeSH
• Light Coagulation * MeSH
• Humans MeSH
• Retinal Vein Occlusion surgery   MeSH
• Prognosis MeSH
• Retinal Vein surgery   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Argon MeSH

• Keywords
• MESENTERIC VASCULAR OCCLUSION *,
• MeSH
• Humans MeSH
• Mesenteric Vascular Occlusion * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

Central retinal artery occlusion (CRAO) is a form of acute ischemic stroke. It is a critical condition that often leads to severe visual loss or blindness and can be a harbinger of further cerebrovascular events. Due to the lack of scientific data, there are no effective evidence-based forms of therapy for this condition. None of the conservative therapies have proven effective. The results of some previously published studies suggest a benefit of intravenous thrombolytic therapy in the same regimen as in the treatment of ischemic stroke. This work aims to present an overview of published clinical studies focused on the use of intravenous thrombolysis for CRAO, evaluate its efficacy and safety, and propose an optimal diagnostic and therapeutic algorithm for acute management of CRAO. Summary statistics of patient data from relevant studies indicate that a significant visual acuity improvement was achieved by a total of 45 % of patients receiving alteplase within 4.5 hours of symptoms onset. The occurrence of adverse events in this time window was not significant. Intravenous thrombolytic therapy in CRAO thus appears to be effective and safe. However, we still lack data from adequate prospective randomized controlled trials to confirm this conclusion. To date, two randomized trials are being conducted. The intravenous thrombolysis administration, patient monitoring, etiologic workup, and setting of effective secondary prevention should be ensured at the centre of highly specialized cerebrovascular care. Urgent transport of the CRAO patient to the nearest centre is essential.

• Keywords
• Visual acuity, alteplase, central retinal artery occlusion, thrombolysis,
• MeSH
• Fibrinolytic Agents therapeutic use   MeSH
• Ischemic Stroke * MeSH
• Humans MeSH
• Retinal Artery Occlusion * drug therapy   MeSH
• Prospective Studies MeSH
• Thrombolytic Therapy adverse effects   methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Names of Substances
• Fibrinolytic Agents MeSH

PURPOSE: Describe the clinical finding and course of treatment in patients with a sudden decrease in visual function due to an acute occlusion of the arteria centralis retinae. Patients were primarily indicated for selective angiography with thrombolysis of the ophthalmic artery. MATERIALS AND METHODS: Medical documentation of two patients with acute central retinal artery occlusion with a time duration of up to 5 hours was evaluated retrospectively. The diagnosis of central retinal artery occlusion was determined on the basis of a detailed ophthalmological examination in arteficial mydriasis. The initial best-corrected visual acuity (BCVA) were hand movement in front of the eye with uncertain light projection in first patient and no light perception in the second patient. In both cases a relative afferent pupillary defect of the 4th degree was present with the onset of the ischemic macular edema and an incipient development of the cherry red spot. After evaluation of the overall condition, laboratory findings, exclusion of cancer and surgery in the last three months, a selective angiography of ophthalmic artery and thrombolysis in collaboration with the intervention radiologist were performed. Results: First patient with a better initial visual acuity, selective angiography demonstrated a decrease in flow in the central retinal artery with subsequent improvement in haemodynamic ratios after application of 12 ml of recombinant tissue plasminogen activator (Alteplase). The BCVA improved to 1/ 60 after interventional procedure. We did not experience any serious treatment side effects during or after intervention. In the second patient, selective angiography of the intracranial arteries and internal carotids revealed the presence of an aneurysm before the ophthalmic artery. Due to the normal flow of the contralateral carotid and the filling of the intracranial vessels on the affected side via the circle of Willis, the internal carotid ligation was performed under the aneurysm. Three months after the surgery BCVA was no light perception and patient had no neurological symptomatology. CONCLUSION: Selective angiography in combination with thrombolysis appears to be a useful imaging as well as therapeutic method for acute central retinal artery occlusion. This technique allows not only to confirm the diagnosis but it can also solve problem causally and improve the visual acuity of the affected person. Sometimes it also helps to clear the cause of the closure and prevent next potential embolization into the intracranial space and possible fatal consequences of CNS involvement or even death.

• Keywords
• CRAO, Selective angiography, aneurysm of the internal carotid artery, central retinal artery occlusion, recombinant tissue plasminogen activator, thrombolysis,
• MeSH
• Angiography * MeSH
• Humans MeSH
• Retinal Artery Occlusion * diagnostic imaging   drug therapy   MeSH
• Retrospective Studies MeSH
• Tissue Plasminogen Activator * MeSH
• Thrombolytic Therapy MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Tissue Plasminogen Activator * MeSH

BACKGROUND: Retinal artery occlusion is an extremely rare diagnosis in the pediatric population and the etiology with risk factors of retinal artery occlusion are poorly understood in younger individuals. METHODS AND RESULTS: This case report a rare case of transient branch retinal artery occlusion (BRAO) in a healthy young girl. A fifteen-year-old girl presented with painless decreased vision in her right eye. Fundus examination revealed in the right eye intensive edema of the part of superior half of the retina, but the vessels were absolutely normal. She was hospitalized for diagnosis and treatment. A thorough workup was performed to determine any etiologic factor. Her physical examination was normal, but from anamnesis has been found that patient began use oral contraception at the time of occurrence eye problems. The condition is evaluated as transient branch retinal artery occlusion by the course of the disease. The paper includes the review of the literature also. CONCLUSION: Though retinal arterial obstruction is rare in the pediatric population, this case highlights the importance of including this in the differential diagnosis of acute vision loss.

• Keywords
• branch retinal artery occlusion (BRAO), oral contraception, pediatric population,
• MeSH
• Acute Disease MeSH
• Fluorescein Angiography MeSH
• Fundus Oculi MeSH
• Contraceptives, Oral adverse effects   MeSH
• Humans MeSH
• Adolescent MeSH
• Follow-Up Studies MeSH
• Recovery of Function * MeSH
• Retinal Artery Occlusion chemically induced   diagnosis   physiopathology   MeSH
• Tomography, Optical Coherence MeSH
• Retina pathology   MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH
• Review MeSH
• Names of Substances
• Contraceptives, Oral MeSH

PURPOSE: functional and anatomical results after combination of intravitreal dexamethasone implant with anti-VEGF bevacizumab in macular edema secondary to retinal vein occlusion. METHODS: Retrospective analysis of 50 patients, average age 72 years, 15 men and 35 women. Inclusion criteria for treatment were retinal vein occlusion, best corrected visual acuity (BCVA) more than 20/200 and macular edema more than 250 μm. Algorithm of treatment was dexamethason, anti-VEGF (bevacizumab), dexamethason. Application of anti-VEGF bevacizumab was in interval between two applications of dexamethasone, for the first time in every patient. If there were nonperfusion areas on fluoresceine angiography (FA), or ischemia on slit lamp, repeatedly. Patients observed for 12 months at least. This cohort included patients with branch retinal vein occlusion together with central retinal vein occlusion. This is an evaluation of nonperfusion areas based on FA, BCVA, macular edema on optical coherence tomography (OCT) and number of reapplication of anti-VEGF bevacizumab. Observed adverse effects are elevation of intraocular pressure and number of patients who underwent cataract surgery. RESULTS: The gain of 8 letters in 1st month after 1st application of dexamethasone, central retinal thickness (CRT) reduced from 512 μm to 318 μm in average. 33 patients get 1, 3 patients get 2 and 14 patients 3 injections of bevacizumab. On the day of 2nd application of dexamethasone, in 7th month in average, the CRT increased on 465 μm, and 1th month after, the gain from the baseline was 10 letters and CRT reduced on 380 μm. All the patients were phackic at the baseline, 18 (36 %) patients underwent cataract surgery with intraocular lens implantation. Transient elevation of intraocular pressure in 15 (30 %) eyes, treated by local therapy. CONCLUSION: Combination of intravitreal dexamethasone implant with anti-VEGF bevacizumab is functionally and anatomically effective. Key words: retinal vein occlusion, macular edema, dexamethasone, bevacizumab.

• Keywords
• bevacizumab, dexamethasone, macular edema, retinal vein occlusion,
• MeSH
• Bevacizumab MeSH
• Dexamethasone MeSH
• Glucocorticoids * administration & dosage   MeSH
• Adrenal Cortex Hormones MeSH
• Intravitreal Injections MeSH
• Humans MeSH
• Macular Edema * drug therapy   etiology   MeSH
• Retinal Vein Occlusion * complications   MeSH
• Tomography, Optical Coherence MeSH
• Retrospective Studies MeSH
• Aged MeSH
• Vascular Endothelial Growth Factor A * antagonists & inhibitors   MeSH
• Treatment Outcome MeSH
• Visual Acuity MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Bevacizumab MeSH
• Dexamethasone MeSH
• Glucocorticoids * MeSH
• Adrenal Cortex Hormones MeSH
• Vascular Endothelial Growth Factor A * MeSH

In branch retinal vein occlusion (BRVO), abnormal arteriovenous crossing with vein compression, degenerative changes of the vessel wall and abnormal hematological factors constitute the primary mechanism of vessel occlusion. In general, BRVO has a good prognosis: 50-60% of eyes are reported to have a final visual acuity (VA) of 20/40 or better even without treatment. One important prognostic factor for final VA appears to be the initial VA. Grid laser photocoagulation is an established treatment for macular edema in a particular group of patients with BRVO, while promising results for this condition are shown by intravitreal application of steroids or new vascular endothelial growth factor inhibitors. Vitrectomy with or without arteriovenous sheathotomy combined with removal of the internal limiting membrane may improve vision in eyes with macular edema which are unresponsive to or ineligible for laser treatment.

• MeSH
• Basement Membrane surgery   MeSH
• Decompression, Surgical MeSH
• Humans MeSH
• Retinal Vein Occlusion etiology   physiopathology   surgery   MeSH
• Prognosis MeSH
• Vitrectomy MeSH
• Visual Acuity physiology   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

Central retinal artery occlusion (CRAO) is a form of acute ischemic stroke. It is a critical condition that often leads to severe visual loss or blindness and can be a harbinger of further cerebrovascular events. Due to the lack of scientific data, there are no effective evidence-based forms of therapy for this condition. None of the conservative therapies have proven effective. The results of some previously published studies suggest a benefit of intravenous thrombolytic therapy in the same regimen as in the treatment of ischemic stroke. This work aims to present an overview of published clinical studies focused on the use of intravenous thrombolysis for CRAO, evaluate its efficacy and safety, and propose an optimal diagnostic and therapeutic algorithm for acute management of CRAO. Summary statistics of patient data from relevant studies indicate that a significant visual acuity improvement was achieved by a total of 45 % of patients receiving alteplase within 4.5 hours of symptoms onset. The occurrence of adverse events in this time window was not significant. Intravenous thrombolytic therapy in CRAO thus appears to be effective and safe. However, we still lack data from adequate prospective randomized controlled trials to confirm this conclusion. To date, two randomized trials are being conducted. The intravenous thrombolysis administration, patient monitoring, etiologic workup, and setting of effective secondary prevention should be ensured at the centre of highly specialized cerebrovascular care. Urgent transport of the CRAO patient to the nearest centre is essential.

• Keywords
• Visual acuity, alteplase, central retinal artery occlusion, thrombolysis,
• MeSH
• Stroke * complications   drug therapy   MeSH
• Brain Ischemia * MeSH
• Humans MeSH
• Retinal Artery Occlusion * drug therapy   MeSH
• Prospective Studies MeSH
• Thrombolytic Therapy MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

INTRODUCTION: The indications for popliteal artery aneurysm treatment are clear. In aneurysms with patent inflow and outflow arteries, the risk of peripheral embolisation from a mural thrombus is high and the treatment, mostly a vascular intervention, is focused on preventing this extremity-threatening complication. It is unclear, however, how high the risk of peripheral embolisation is and how to proceed with a patent popliteal artery aneurysm fed by the deep femoral artery when the superficial femoral artery is chronically occluded. METHODS: All patients diagnosed with popliteal artery aneurysm between 2015 and 2019 were searched in the database of the Department of Surgery II of University Hospital Olomouc. Patients with a patent popliteal artery aneurysm and chronic superficial femoral artery occlusion in the ipsilateral extremity were selected. RESULTS: We diagnosed 66 patients with 85 popliteal artery aneurysms. Four patients had a patent popliteal artery aneurysm and chronic superficial femoral artery occlusion in the ipsilateral extremity. In these patients, conservative treatment was indicated after the diagnosis was determined. In three patients, no clinically obvious complication of the popliteal artery aneurysm occurred. In one patient, popliteal artery aneurysm thrombosis occurred after a follow-up of 21 months, leading to a shortening of his calf claudication distance and limiting the patient. CONCLUSION: Our experience with this small group of patients shows the possibility of primary conservative treatment in patients with a patent popliteal artery aneurysm below the chronic superficial femoral artery occlusion site. Aneurysm thrombosis can be expected during follow-up. Patients in whom the thrombosis leads to limitations are indicated for surgical intervention. The risk of peripheral embolisation from the mural thrombus cannot be excluded with certainty. Further studies involving large groups of patients are needed to provide a more precise recommendation.

• Keywords
• chronic superficial femoral artery occlusion, popliteal artery aneurysm,
• MeSH
• Aneurysm * complications   diagnostic imaging   surgery   MeSH
• Femoral Artery diagnostic imaging   surgery   MeSH
• Popliteal Artery diagnostic imaging   surgery   MeSH
• Arterial Occlusive Diseases * diagnostic imaging   surgery   MeSH
• Humans MeSH
• Thrombosis * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH