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Histopathological Changes of the Retina After Nd: YAG Laser Thrombolysis in Branch Retinal Vein Occlusion: An Experimental Study

Salwa Ahmed Abdelkawi, Aziza Ahmed Hassan, Dina Fouad Ghoneim, Ahmed Tamer Sayed Saif
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Abstract

Introduction: The efficacy of many therapeutics techniques for treatment of branch retinal vein occlusion (BRVO) has been the subject of many investigations. The aim of the present work is to evaluate the transluminal Nd: YAG laser thrombolysis as a new therapeutic approach used for treatment of BRVO in rabbits as an experimental model.
Methods: Four rabbits were considered as a control (n=8 eyes); occlusion of the branch retinal veins was performed by using a dye enhancing thrombus formation in right eyes of 10 rabbits (n=10 eyes). Thrombi in the retinal veins were induced by intravenous injection of rose bengal solution as a photosensitizer immediately before the argon laser application with a power of 1200 mW, a spot size of 100 μm, and a duration of 20 ms. One week later, transluminal Nd: YAG laser thrombolysis (30 mJ, 3 pulses/4 ns) was employed to the site of occluded veins, until the thrombi were partially or completely shattered. The rabbits were followed up after 4 days, 1 week and 2 weeks for slit lamp fundus examination and the treated retinas were isolated for histopathological examination.
Results: Argon laser photothrombosis induced complete BRVO with some vitreous hemorrhage, destruction, and necrosis in the surrounding retinal layers. Moreover, one week later, Nd: YAG laser thrombolysis showed complete venous flow, minimal vitreous hemorrhage, reperfused retina, complete veins improvement. Follow up after 2 weeks revealed more improvement of all retinal layers.
Conclusion: Treatment with transluminal Nd: YAG laser thrombolysis represented a novel therapeutic modality in BRVO.

Keywords

Branch retinal vein occlusion; Photothrombosis; Rose bengal; Thrombolysis; Lasers.

References

Arséne S, Giraudeau B, Le Lez ML, et al. Follow up by colour doppler imaging of 102 patients with retinal vein occlusion over 1 year. Br J Ophthalmol. 2002;86:1243–47.

Rogers S, McIntosh RL, Cheung N, et al. The prevalence of retinal vein occlusion:pooled data from population studies from the United States, Europe, Asia, and Australia. Ophthalmology. 2010;117:313-1319. doi:10.1016/j. ophtha.2009.07.017

Hamid S, Mirza SA, Shokh I. Branch retinal vein occlusion. J Ayub Med Coll Abbottabad. 2008;20:128-132.

Leibreich R. Apoplexia retinae. Graefes Arch Ophthalmol. 1855;1:346–51.

Von Michel J. Die spontane thrombose der vena centralis des opticus. Graefes Arch Ophthalmol. 1878;24:37–70.

Hayreh SS. Prevalent misconceptions about acute retinal vascular occlusive disorders. Prog Retin Eye Res. 2005;24:493–519. doi:10.1016/j.preteyeres.2004.12.001

Rehak M, Wiedemann P. Retinal vein thrombosis: pathogenesis and management. J Thromb Haemost. 2010;8:1886-1894.

Duker JS, Brown GC. Anterior location of the crossing artery in branch retinal vein obstruction. Arch Ophthalmol. 1989;107:998-1000.

Klein R, Klein BE, Moss SE, Meuer SM. The epidemiology of retinal vein occlusion: The Beaver Dam Eye Study. Trans Am Ophthalmol Soc. 2000;98:133-141.

Sperduto RD, Hiller R, Chew E, et al. Risk factors for hemiretinal vein occlusion: comparison with risk factors for central and branch retinal vein occlusion: the eye disease case-control study. Ophthalmology. 1998;105:765- 771. doi:10.1016/S0161-6420(98)95012-6

Recchia FM, Brown GC. Systemic disorders associated with retinal vascular occlusion. Curr Opin Ophthalmol. 2000;11:462-467.

Shoch D. Etiologic diagnosis of retinal venous stasis and occlusion. Trans Pac Coast Oto ophthalmol Soc Annu Meet. 1978;51:127.

O’Mahoney PRA, Wong DT, Ray JG. Retinal vein occlusion and traditional risk factors for atherosclerosis. Arch Ophthalmol. 2008;126:692-699. doi:10.1001/ archopht.126.5.692

Ring CP, Pearson TC, Sanders MD, Wetherley G. Viscosity and retinal vein thrombosis. Br J Ophthalmol. 1976;60:397- 410.

Zhou JQ, Xu L, Wang S, et al. The 10-year incidence and risk factors of retinal vein occlusion: the Beijing eye study. Ophthalmology. 2013;120:803-808. doi:10.1016/j. ophtha.2012.09.033

Rehak JR, Rehak M Branch retinal vein occlusion: pathogenesis, visual prognosis, and treatment modalities. Curr Eye Res. 2008;33:111-131. doi:10.1080/02713680701851902

Janssen MCH, Heijer M, Cruysberg JRM, et al. Retinal vein occlusion:a form of venous thrombosis or a complication of atherosclerosis? A meta-analysis of thrombophilic factors. Thromb Haemost. 2005;93:1021-1026.

Mitchell P, Smith W, Chang A. Prevalence and associations of retinal vein occlusion in Australia: the blue mountains eye study. Arch Ophthalmol. 1996;114:1243-1247.

Chatziralli IP, Jaulim A, Peponis VG, et al. Branch retinal vein occlusion: treatment modalities: an update of the literature. Semin Ophthalmol. 2014;29:85-107.

Jaulim A, Ahmed B, Khanam T, Chatziralli IP. Branch retinal vein occlusion: epidemiology, pathogenesis, risk factors, clinical features, diagnosis, and complications. An update of the literature. Retina. 2013;33:901-910. doi:10.1097/IAE.0b013e3182870c15

Jefferies P, Clemett RS, Day T. An anatomical study of retinal arteriovenous crossings and their role in the pathogenesis of retinal branch vein occlusions. Aust NZ J Ophthalmol. 1993;21:213-217.

Christoffersen NLB, Larsen M. Pathophysiology and hemodynamics of branch retinal vein occlusion. Ophthalmology. 1999;106:2054-2062. doi:10.1016/S0161- 6420(99)90483-9

Zhao J, Sastry SM, Sperduto RD, Chew EY, Remaley NA. Arteriovenous crossing patterns in branch retinal vein occlusion: The Eye Disease Case-Control Study Group. Ophthalmology. 1993;100:423-428.

Sekimoto M, Hayasaka S, Setogawa T. Type of arteriovenous crossing at site of branch retinal vein occlusion. Jpn J Ophthalmol. 1992;36:192–196.

Spaide RF, Lee JK, Klancnik JK, Gross NE. Optical coherence tomography of branch retinal vein occlusion. Retina. 2003;23:343-347.

Oncel M, Peyman GA, Khoobehi B. Tissue plasminogen activator in the treatment of experimental retinal vein occlusion. Retina. 1989;9:1–7.

Laatikainen L, Kohner EM, Khoury D, Blach RK. Panretinal photocoagulation in central retinal vein occlusions: A randomised controlled clinical study. Br J Ophthalmol. 1977;61:741-753.

Hesberg RJ. X-ray treatment thrombosis of the retinal vein and of several types of iridocyclitis. Am J Ophthalmol. 1944;27:864-875.

Vannas S, Orma H. Experience of treating retinal venous occlusion with anticoagulant and antisclerosis therapy. Arch Ophthalmol. 1957;58:812-828.

Clements DB, Elsby JM, Smith WD. Retinal vein occlusion: A cooperative study of factors affecting the prognosis, including a therapeutic trial of Atromid-S in this condition. Br J Ophthalmol. 1968;52:111-116.

Kohner EM, Pettit JE, Hamilton AM, Bulpitt CJ, Dollery CT. Streptokinase in central retinal vein occlusions: a controlled clinical trial. Br Med J. 1976;1:550-553.

Green WR, Chan CC, Hutchins GM, Terry J. Central retinal vein occlusion: a prospective histopathologic study of twenty-nine eyes in twenty-eight cases. Trans Am Soc Ophthalmol. 1981;89:371-422.

Branch Vein Occlusion Study Group. Argon laser photocoagulation for macular edema in branch vein occlusion. Am J Ophthalmol. 1984;98:271-282.

Branch Vein Occlusion Study Group. Argon laser scatter photocoagulation for prevention of neovascularization and vitreous hemorrhage in branch vein occlusion. A randomized clinical trial. Arch Ophthalmol. 1986;104:34- 41.

Osterloh MD, Charles S Surgical decompression of branch retinal vein occlusions. Arch Ophthalmol. 1988;106:1469- 1471.

Hansen LL, Wiek J, Wiederholt M. A randomised prospective study of treatment of non-ischaemic central retinal vein occlusion by isovolaemic haemodilution. Br J Ophthalmol. 1989;73:895-899.

Saika S, Tanaka T, Miyamoto T, Ohnishi Y. Surgical posterior vitreous detachment combined with gas/air tamponade for treating macular edema associated with branch retinal vein occlusion: retinal tomography and visual outcome. Graefes Arch Clin Exp Ophthalmol. 2001;239:729-732.

Mandelcorn MS, Nrusimhadevara RK. Internal limiting membrane peeling for decompression of macular edema in retinal vein occlusion. A report of 14 cases. Retina. 2004;24:348-355.

Cekic O, Chang S, Tseng JJ, et al. Intravitreal triamcinolone injection for treatment of macular edema secondary to branch retinal vein occlusion. Retina. 2005;25:851-855.

Noma H, Funatsu H, Yamasaki M, et al. Pathogenesis of macular edema with branch retinal vein occlusion and intraocular levels of vascular endothelial growth factor and interleukin-6. Am J Ophthalmol. 2005;140:256-61. doi:10.1016/j.ajo.2005.03.003

Genevois O, Paques M, Simonutti M, et al. Microvascular remodeling after occlusion- recanalization of a branch retinal vein in rats. Invest Ophthalmol Vis Sci. 2004;45:594- 600.

Chidlow G, Shibeeb O, Plunkett M, Casson RJ, Wood JP. Glial cell and inflammatory response to retinal laser treatment: comparison of a conventional photocoagulator and a novel, 3-nanosecond pulse laser. Invest Ophthalmol Vis Sci. 2006;54:2319-2332. doi:10.1167/iovs.12-11204

Daniel P, Mark B, John W. Retinal laser therapy:Biophysical basis and applications. In: Ryan. SJ, Schachat AP, Wilkinson CP, Hinton DR, Sadda SR, Wiedemann. P, eds. Retina. 5th ed. vol 3. St. Louis: Mosby Inc; 2012.




DOI: https://doi.org/10.22037/jlms.v10i1.17366