Characteristic Manifestation And Related Study Of Optical Coherence Tomography In Retinal Vein Occlusion

Part 1:Correlation between hyperreflective dots in optical coherence tomography and blood lipid levels and inflammation in patients with retinal vein occlusion.Objective:To investigate the correlation between hyperreflective dots(HRD)and lipid levels and systemic inflammatory factors in patients with BRVO and CRVO.Methods:A cross-sectional clinical study.From December 2016 to June 2020,125 eyes of 125 patients with retinal vein occlusion diagnosed in hospital were included in the study.According to the location of the disease,they were divided into BRVO group and CRVO group.Peripheral venous blood was drawn from the patients within 3 days after the eye examination to detect the percentage of neutrophils,monocytes,hypersensitive C-reactive protein(CRP),total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,and lipoprotein(a).The ratio of monocytes to high-density lipoprotein(MHR)was also calculated.The OCT instrument was used to measure the central retinal thickness(CRT)and the numbers of HRD.According to the different distribution position,HRD is divided into inner retina HRD,outer retina HRD,and total retina HRD.Observe and compare the above indicators of the two groups of patients,and use Pearson or Spearman correlation analysis to test the correlation between the HRD and blood lipid levels and inflammation indicators.Results:The average age of patients in the BRVO group and CRVO group were(59.7±9.6)and(53.0±15.7)years,respectively;the prevalence of hypertension was50.0%and 24.5%,respectively.Comparison of age(t=2.756)and prevalence of hypertension(?~2=9.660)between the two groups showed statistically significant differences.Gender(?~2=2.0),course of disease,prevalence of diabetes,eye category,baseline visual acuity,intraocular pressure,CRT,the HRD in the inner retina,the HRD in the outer retinal,total HRD and peripheral blood include the percentage of neutrophils,the absolute number of monocytes,CRP,total cholesterol,triglycerides,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,lipoprotein(a),MHR,the difference was not statistically significant.Correlation analysis showed that the HRD counts in the outer retina of BRVO patients were positively correlated with total cholesterol(r=0.297,P=0.025);the HRD in the inner retina and total HRD counts of CRVO patients were positively correlated with CRP(r=0.346,0.285,P=0.014,0.045).There was no correlation between HRD counts and percentage of neutrophils,absolute number of monocytes,triglycerides,high-density lipoprotein,low-density lipoprotein,lipoprotein(a),and MHR(all,P>0.05).Conclusions:The number of HRD is related to the blood lipid level in BRVO patients;it is related to CRP,an inflammatory index in CRVO patients.Part 2:Correlation between optical coherence tomography and anti-VEGF therapy in patients of different ages with central retinal vein occlusionObjective:To explore the correlation between age,OCT characteristics and the efficacy of anti-vascular endothelial growth factor(VEGF)drugs in the treatment of macular edema secondary to central retinal vein occlusion(CRVO).Methods:Retrospective case-control study.From July 2017 to July 2019,47 eyes of 47 patients with CRVO were included and divided into group A(elderly group,age> 50 y,n=27)and group B(young and middle-aged group,age ≤ 50 y,n=20).All patients were received anti-VEGF therapy(3+PRN)and followed up for at least 12 months.The best corrected visual acuity(BCVA),the number of hyperreflective dots(HRD),the average retinal thickness(ART)and central retinal thickness(CRT)were observed before and after treatment.The numbers of injection,the recovery rate of outer membrane(ELM)and ellipsoidal zone(EZ)were compared between the two groups,and the related indexes affecting visual prognosis were analyzed.Results:After anti-VEGF treatment,BCVA was improved,the number of HRD decreased,CRT and ART thinned in both groups.During the follow-up of 12 months after treatment,the numbers of injection of anti-VEGF drugs in the elderly group was higher than that in the young and middle-aged group(8.4 ±2.1times vs 7.3times,P=0.047),but there was no difference in the recovery rates of ELM and EZ between the two groups.BCVA in the elderly group was correlated with the age,HRD,ELM and EZ(all P < 0.05).BCVA was correlated with age,ART,HRD,ELM and EZ in young and middle-aged patients.Conclusions:Intravitreal injection of anti-VEGF drugs can effectively treat macular edema secondary to CRVO and the prognosis of young and middle-aged patients is better than that of elderly patients.Age and OCT indexes such as HRD,ELM and EZ are related to visual prognosis.