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Objective: Lifestyle risk factors vary between socioeconomic status (SES) groups and may influence cardiovascular function differently. The retinal microvasculature allows for monitoring early changes in cardiovascular health, and therefore, we investigated whether retinal vessel calibers associate differently with modifiable risk factors in different SES groups. Methods: We included 1064 young adults (aged 20–30 years) grouped by low and high SES. The central retinal artery and vein equivalents (CRAE, CRVE) were determined from fundus images captured using the Dynamic Retinal Vessel Analyzer (Imedos Systems GmbH, Jena, Germany). We collected anthropometry, self‐reported alcohol consumption, and biochemical data. Results: Retinal vessel calibers did not differ between SES groups (p ≥.80) after adjusting for sex and ethnicity. Unique independent associations were observed in the low SES group, where CRAE (β = 0.08, p =.042) and CRVE (β =.14, p =.001) associated positively with cotinine and body mass index, respectively. In the high SES group, CRAE (β = –0.09, p =.027) associated negatively with alcohol consumption. Conclusion: At young ages, retinal vessel calibers associated differently with modifiable lifestyle risk factors within each SES group. Our data highlight the importance of detecting adverse lifestyle risk factors among young adults from diverse socioeconomic settings to improve prevention of cardiovascular disease. [ABSTRACT FROM AUTHOR]

Background: Vision health is an important aspect of health worldwide. Visual impairment (VI) is associated with poor quality of life and is usually more prevalent in rural areas. To help rural populations obtain vision care, health insurance policies have emerged throughout the world. However, some existing literatures show that health insurance enrollment's impact on the overall physical health of rural population has been minimal. Focusing on vision health among adults in rural China, our study aims to investigates the impact of health insurance on vision health, heterogeneity of the effect, and the moderating effect of health insurance enrollment on the impact of chronic physical diseases and basic eye diseases on vision health.Methods: Primary data were collected through a nation-wide epidemiological survey of vision health conducted in rural China in 2018, with a sample size of 28,787 used in our statistical analysis. Instrumental variables regression and Heckman selection models were conducted to examine the impact of health insurance enrollment and reimbursement ratio adults' vision health outcomes. Subsample regressions by sex, age, education level, and whether with eye diseases were further conducted to explore the heterogeneity in our results. We then examined whether health insurance enrollment moderates the impact of chronic physical diseases and basic eye diseases on vision health through the method of introducing interaction terms.Results: Participating in health insurance reduced the probability of VI by 2.15 %. The reimbursement rate increasing by 1 % point may reduce the probability of worsening VI by 6.12 %. Men (-0.0235, P = 0.0002) benefit more from insurance enrollment than women (-0.0201, P = 0.0082) with respect to vision health. From the young adult group to the oldest group, the marginal effect of health insurance increased from - 0.0068 (P = 0.0394) to -0.0753 (P < 0.0001). The marginal effect on VI was most significant in people with lower education levels and weakened with increased education levels. People with basic eye diseases (-0.0496, P = 0.0033) benefit more from participating insurance than the people without basic eye diseases (-0.0196, P = 0.0001) with respect to vision health. The moderating effects of health insurance enrollment on the impacts of cerebral infarction (-0.1225, P < 0.0001), diabetes (-0.0398, P = 0.0245), hyperlipidemia (-0.1364, P = 0.0271), mental illness (-0.1873, P = 0.0010), glaucoma (-0.1369, P = 0.0073), diabetic retinopathy (-0.1560, P = 0.0043), and retinal vein obstruction (-0.2018, P = 0.0155) on vision health were significantly negative.Conclusions: The results suggest that participation in health insurance and higher health insurance reimbursement ratios reduced the risk of VI in the sampled adults. Health insurance has the most significant effect in in vulnerable groups. Heath insurance enrollment moderates the impacts of several chronic physical and basic eye conditions on vision health. Our findings have potential implications for reforming health insurance policies to improve vision health conditions in rural areas of developing countries. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare the retinal vascular caliber of COVID-19 patients with that of healthy subjects. Methods: This was a prospective case–control study. Forty-six patients who had COVID-19 were successfully treated, and 38 age- and gender-matched healthy subjects were enrolled in this study. Fundus photography was taken using fundus fluorescein angiography (FA; Visucam 500; Carl Zeiss Meditec, Jena, Germany). Retinal vascular caliber was analyzed with IVAN, a semi-automated retinal vascular analyzer (Nicole J. Ferrier, College of Engineering, Fundus Photography Reading Center, University of Wisconsin, Madison, WI, USA). Central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and artery–vein ratio (AVR) were compared between groups. Results: The mean age was 37.8 ± 9.5 years in the COVID-19 group (n = 46) and 40 ± 8 years in the control group (n = 38) (p = 0.45). The mean CRAE was 181.56 ± 6.40 in the COVID-19 group and 171.29 ± 15.06 in the control group (p = 0.006). The mean CRVE was 226.34 ± 23.83 in the COVID-19 group and 210.94 ± 22.22 in the control group (p = 0.044). AVR was 0.81 ± 0.09 in the COVID-19 group and 0.82 ± 0.13 in the control group (p = 0.712). Conclusion: Patients who had COVID-19 have vasodilation in the retinal vascular structure after recovery. As they may be at risk of retinal vascular disease, COVID-19 patients must be followed after recovery. [ABSTRACT FROM AUTHOR]

Background: Retinal vein occlusion (RVO) is the second most common sight threatening retinal vascular disorder after diabetic retinopathy. Retinal vein occlusion is a common form of retinal vascular disease, especially in middle-aged and older individuals. Occlusion results due to thrombotic effect on the retinal vein. BRVO is classified according to the anatomical location as major or macular. Major BRVO refers to occlusion of a retinal vein that drains one of the quadrants. Macular BRVO refers to occlusion of a venule within the macula. BRVO is further classified into perfused (non-ischemic) or non-perfused (ischemic). Ischemic BRVO is defined as > 5 disc diameters of nonperfusion on fluorescein angiography (FA). Objectives: To study pre and post treatment (Intravitreal Bevacizumab 1.25mg/0.05ml)OCT in patients with macular edema secondary to BRVO. Material And Methods: 30 Eyes of 30 patients of BRVO with macular edema were studied retrospectively who attended eye opd during Sept-2012 to Aug-2014 according inclusion and exclusion criteria After routine ophthalmic examination with slit lamp biomicroscopy and dilated fundus examination with indirect ophthalmoscope and preop OCT done for CFT(central foveal thickness)patient underwent intravitreal injection anti VEGF. Post treatment OCT of these patients were reviewed after 1 week and 1 month retrospectively. Result: Significant improvements in CFT were observed in these patients after treatment. Results were analyzed based on the duration Of the treatment given, after 1 week and after 1 month. Conclusion: Early diagnosis & treatment of the pathology contributes to the better visual outcome. [ABSTRACT FROM AUTHOR]

Purpose: The pathomechanism leading to retinal vein occlusion (RVO) is unclear. Mechanical compression, thrombosis, and functional contractions of veins are discussed as the reasons for the increased resistance of venous outflow. We evaluated changes in the retinal venous pressure (RVP) following intravitreal injection of anti-vascular endothelial growth factor (VEGF) agent to determine the effect on RVO-related macular edema. Methods: Twenty-six patients with RVO-related macular edema (16 branch RVOs [BRVOs] and 10 central RVOs [CRVOs], age 72.5 ± 8.8 years) who visited our hospital were included in this prospective study. Visual acuity (VA), intraocular pressure (IOP), central retinal thickness (CRT) determined by macular optical coherence tomography, and RVP measured using an ophthalmodynamometer were obtained before intravitreal injection of ranibizumab (IVR) and 1 month later. Results: Comparison of the BRVOs and CRVOs showed that VA was significantly improved by a single injection in BRVOs (P < 0.0001; P = 0.1087 for CRVOs), but CRT and RVP were significantly decreased without significant difference in IOP after the treatment in both groups (P < 0.0001). Conclusion: The anti-VEGF treatment resulted in a significant decrease in the RVP, but the RVP remained significantly higher than the IOP. An increased RVP plays a decisive role in the formation of macula edema, and reducing it is desirable. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the longitudinal changes in retinal vessel diameters in patients with coronavirus disease 2019 (COVID-19). Methods: This study included 25 patients with COVID-19 (Group 1) and 25 healthy subjects (Group 2). The diameters of peripapillary temporal and nasal retinal arteries and veins were measured at baseline and at 4 months after remission. Results: The baseline diameters of the inferior temporal vein and the artery were increased in group 1 compared to controls (p =.007 and p =.041, respectively). There was also an increase in the diameters of the inferior and superior nasal veins and arteries in group 1 at baseline (p =.001, p =.019, p =.037, and p =.008, respectively). Retinal vessel diameters decreased after remission in all quadrants in comparison to baseline measurements (all p <.05). Conclusion: Increased retinal vessel diameters were measured in COVID-19 patients during the disease. Measurement of retinal vessel diameters may be a noninvasive method of estimating the vascular risk. [ABSTRACT FROM AUTHOR]

In the article, the authors present the cases of a 21-year-old African American woman in Brazil who was found to have deep arcuate scotoma in her right eye and a ring-shaped scotoma in her left eye and a 71-year-old woman who was rushed to a hospital due to progressive visual loss in both eyes to discuss the condition called pigmented paravenous retinochoroidal atrophy (PPCRA). Other topics include chorioretinal atrophy, and their differential diagnosis like angioid streaks and sarcoidosis.

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PURPOSE: To investigate the relationship of spontaneous venous pulsation (SVP) with disc hemorrhage (DH) in open-angle glaucoma (OAG). METHODS: Spontaneous venous pulsation was assessed and compared using a confocal scanning laser ophthalmoscope movie tool in 52 eyes of 52 patients with DH, and 111 eyes of 111 patients in without DH. Logistic regression analysis was used to determine the factors associated with the occurrence of DH. RESULTS: The frequency of SVP was 60.7% in overall patients with OAG. The absence of SVP was associated with lower untreated IOP (OR 0.880; P = 0.045), longer axial length (OR 1.654; P = 0.007), and worse visual field mean deviation (OR 0.884; P = 0.035). The absence of SVP was not significantly associated with DH by logistic analysis (OR 0.844; P = 0.626). Better visual field mean deviation (OR 1.098; P = 0.043), lower untreated IOP (OR 0.886; P = 0.021), and the tendency to cold hands (OR 2.688; P = 0.032) were associated with DH. CONCLUSIONS: In consecutive patients with OAG, the absence of SVP was not associated with DH.

It is rare for young, healthy patients to have retinal venous or arterial occlusions and even rarer for both to occur in concert. Such an occurrence should prompt a rapid and extensive workup to prevent further complications. We present our patient, a 37-year-old Lebanese male, who reported a 3-day history of blurring of vision in his left eye. He had no medical or ocular history and is a nonsmoker. Examination of the left fundus revealed inferior macular edema and retinal whitening associated with tortuous retinal veins. He was diagnosed with a combined central retinal vein and cilioretinal artery occlusion. Emergency treatment was done for an acute arterial occlusion. Embolic and thrombotic causes were excluded with investigations. The only positive result was homozygosity for 677C>T mutation of the 5,10 methylenetetrahydrofolate reductase (MTHFR) enzyme gene. MTHFR enzyme breaks down homocysteine, which is atherogenic and prothrombotic. This mutation can lead to a prothrombotic state, precipitating this occurrence. In fact, the Lebanese population is known to have the highest incidence of such mutations, but there are surprisingly few reports on retinal vascular occlusions attributed to this. He was promptly treated with antiplatelet therapy, possibly preventing a full-blown central retinal vein occlusion. After 4 weeks, his vision improved to 6/6 bilaterally. Examination showed less tortuous veins, no more retinal whitening, resolution of macula edema and visual field defect. Hyperhomocysteinemia can be significant in patients without ischemic risk factors. It is vital to manage these patients promptly, preventing future sight and life-threatening events. [ABSTRACT FROM AUTHOR]

Orbital veins such as the retinal veins and episcleral veins drain into the cavernous sinus, an intracranial venous structure. We studied the effects of acute intracranial pressure (ICP) elevation on episcleral venous pressure, intraocular pressure and retinal vein diameter in an established non-survival pig model. In six adult female domestic pigs, we increased ICP in 5 mm Hg increments using saline infusion through a lumbar drain. We measured ICP (using parenchymal pressure monitor), intraocular pressure (using pneumatonometer), episcleral venous pressure (using venomanometer), retinal vein diameter (using OCT images) and arterial blood pressure at each stable ICP increment. The average baseline ICP was 5.4 mm Hg (range 1.5–9 mm Hg) and the maximum stable ICP ranged from 18 to 40 mm Hg. Linear mixed models with random intercepts were used to evaluate the effect of acute ICP increase on outcome variables. With acute ICP elevation, we found loss of retinal venous pulsation and increased episcleral venous pressure, intraocular pressure and retinal vein pressure in all animals. Specifically, acute ICP increase was significantly associated with episcleral venous pressure (β = 0.31; 95% CI 0.14–0.48, p <.001), intraocular pressure (β = 0.37, 95%CI 0.24–0.50; p <.001) and retinal vein diameter (β = 11.29, 95%CI 1.57–21.00; p =.03) after controlling for the effects of arterial blood pressure. We believe that the ophthalmic effects of acute ICP elevation are mediated by increased intracranial venous pressure producing upstream pressure changes within the orbital and retinal veins. These results offer exciting possibilities for the development of non-invasive ophthalmic biomarkers to estimate acute ICP elevations following significant neuro-trauma. [ABSTRACT FROM AUTHOR]

Background. Increased activity of the NF-κB signaling pathway boosts the progression of retinopathy in diabetic rats. Objectives. Using a bioinformatics website, we identified a site where miR-874 binds to the NF-κB p65. Therefore, we speculated that miR-874 might improve retinopathy in diabetic rats by inhibiting the NF-κB signaling pathway. Materials and methods. Ten healthy rats were taken as the control group. Sixty streptozotocin (STZ; 60 mg/kg)-induced diabetes model rats were randomly divided into the model group (injection of normal saline), negative control (NC) agomir group (injection of NC mimic), miR-874 agomir group (injection of miR- 874 mimic), miR-874 anti-agomir group (injection of miR-874 inhibitor), EVP4593 group (injection of NF-κB signaling pathway antagonist EVP4593), and miR-874 anti-agomir+EVP4593 group (injection of miR-874 inhibitor and EVP4593). All injections were administered into the caudal vein. Results. miR-874 could target the degradation of p65. Compared with the control group, model rats had reduced miR-874 expression, increased vascular endothelial growth factor (VEGF) and Ang2 protein expression, lowered end-diastolic velocity (EDV) and peak systolic velocity (PSV) of the central retinal artery (CRA) and blood velocity of central retinal vein (CRV) and CRA, heightened plasma viscosity (PV), blood viscosity (BV) and erythrocyte sedimentation rate (ESR) at all shear rates, decreased capillary pericytes (IPCs), increased vascular endothelial cells (VECs), and ascended p65 expression in the retina (all p < 0.05). Thus, it was shown that pathological changes appeared in the retina of diabetic rats. These indices improved in diabetic rats injected with the miR-874 mimic or EVP4593, but deteriorated in those injected with miR-874 inhibitor (all p < 0.05). EVP4593 also could alleviate the aggravation of retinopathy that was caused by miR-874 inhibition in diabetic rats. Conclusions. miR-874 modulates the NF-κB signaling pathway by targeting the degradation of p65 to further improve the retina of diabetic rats, thus demonstrating the beneficial effect of miR-874 on diabetic retinopathy in rats. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) including ulcerative colitis and Crohn's disease puts patients at high risk of thromboembolism accidents. These patients may take infliximab for active and fistulating Crohn's disease, which can also increase the risk of thrombosis. Deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) are more common among these patients, but cerebrovascular, mesenteric, portal and retinal veins can also be affected. In this paper, we report a case of isolated right Labbe vein thrombosis after infliximab therapy for Crohn's disease. To the best of our knowledge, our patient is the first case report of isolated cortical vein thrombosis following administration of rituximab for Crohn's disease. [ABSTRACT FROM AUTHOR]

ObjectiveHow 9p21 variation affects risk of cardiovascular disease is unclear, so we assessed whether 9p21 variants are associated with arterial elasticity or retinal microvascular findings.MethodsIn the prospective Multi-Ethnic Study of Atherosclerosis (MESA) we assessed 378 SNPs in the 9p21 locus. Within four ethnic groups, we used an additive genetic model to relate the 9p21 SNPs to five vascular phenotypes: small and large elasticity derived from radial diastolic pulse contour analysis; Young's elastic modulus from carotid artery ultrasound measurements; and the diameter of the central retinal arteries and veins.ResultsIn neither ethnic-specific nor pooled data was there any statistically significant association between any of the 9p21 SNPs and any of the five vascular phenotypes.ConclusionOur study does not support an association of 9p21 variation with arterial elasticity or retinal microvascular abnormalities.

The investigation of artery vein changes over time is considered to be the significant diagnosis process of retinal diseases like diabetic retinopathy. The diagnosis includes the characteristics analysis of artery vein vessels, changes in its tortuosity level and artery vein ratio; hence, it is important to classify the artery and vein in a better way. Computer-aided diagnosis requires the automated classification of retinal artery and vein for diagnosing the progression of diseases. In this paper, a supervised classification with Bat algorithm is proposed to discriminate the artery and vein vessels in the retinal fundus images. A novel feature vector space, including both additive colour space as well as luminous chromaticity model colour space, is constructed. BAT algorithm is applied to select the feature group which improve the classification accuracy and also to reduce the dimensionality of feature space. The proposed method is developed and analyzed using the publicly available databases DRIVE, IOSTAR and STARE. [ABSTRACT FROM AUTHOR]

Purpose: To assess the impact of Jordanian's Corona Virus Disease (COVID-19) lockdown on visual acuity and macular thickness in patients with macular edema receiving intravitreal injections, and to assess the ethical endeavor of lockdown among serious sight threatening conditions. Patients and Methods: This retrospective observational study included patients planned for intravitreal injections who did not complete the planned course before the lockdown (ie, before 20th of March 2020). Data included demographics, indication for the intravitreal injection, corrected distance visual acuity (CDVA), and central macular thickness on Optical Coherence Tomography (OCT) before and after the lockdown. Results: One-hundred and sixty-six eyes of 125 patients were studied, 68 (54.4%) patients were males, and the mean (± standard deviation, SD) age was 64.79 (± 9.41) years. Mean (±SD) duration of delay in the planned injection was 60.97 (± 24.35) days. The change in visual acuity was statistically significant for patients with diabetic macular edema (p= 0.045 improvement), patients with central retinal vein thrombosis (CRVO) (p= 0.05 deterioration), and patients with age-related macular degeneration (AMD) (p= 0.005 deterioration). Of interest, delay of more than 2 months and the previous need for 3 or more injections were significant poor prognostic factors for visual outcome for patients with diabetic macular edema (p=0.027 and 0.045). Conclusion: The impact of delay in the scheduled intravitreal injections resulted in variable outcomes depending on the indication. Triaging the urgency of patients should be based on the indication to support the equity principle of bioethics, where those in need are prioritized against others, depending on potential adverse outcome. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the safety and feasibility of robot‐assisted retinal vein cannulation with Ocriplasmin infusion for central retinal vein occlusion. Methods: Prospective phase I trial including four patients suffering from central retinal vein occlusion (CRVO). Diagnosis was confirmed by preoperative fluo‐angiography and followed by a standard three‐port pars plana vitrectomy. Afterwards, a custom‐built microneedle was inserted into a branch retinal vein with robotic assistance and infusion of Ocriplasmin started. Primary outcomes were the occurrence of intra‐operative complications and success of cannulation. Secondary outcomes were change in visual acuity, central macular thickness (CMT) and venous filling times (VFT) during fluo‐angiography two weeks after the intervention. Results: Cannulation with infusion of ocriplasmin was successful in all four eyes with a mean total infusion time of 355 ± 204 seconds (range 120–600 seconds). Best corrected visual acuity (BCVA) remained counting fingers (CF) in case 3 and 4, increased in case 1 from CF to 0.9LogMAR and decreased in case 2 from 0.4 to 1.3 LogMAR. CMT and VFT both showed a trend towards significant decrease comparing preoperative measurements with two weeks postintervention (1061 ± 541 μm versus 477 ± 376 μm, p = 0.068) and 24 ll 4 seconds versus 15 ± 1 seconds, p = 0.068, respectively). In one eye a needle tip broke and could be removed with an endoforceps. There were no other intervention‐related complications. Conclusion: Robot‐assisted retinal vein cannulation is feasible and safe. Local intravenous infusion with Ocriplasmin led to an improved retinal circulation. [ABSTRACT FROM AUTHOR]

In this study, we report the results of a comprehensive phenotyping of the retina of the AppNL-G-F mouse. We demonstrate that soluble Aβ accumulation is present in the retina of these mice early in life and progresses to Aβ plaque formation by midlife. This rising Aβ burden coincides with local microglia reactivity, astrogliosis, and abnormalities in retinal vein morphology. Electrophysiological recordings revealed signs of neuronal dysfunction yet no overt neurodegeneration was observed and visual performance outcomes were unaffected in the AppNL-G-F mouse. Furthermore, we show that hyperspectral imaging can be used to quantify retinal Aβ, underscoring its potential as a biomarker for AD diagnosis and monitoring. These findings suggest that the AppNL-G-F retina mimics the early, preclinical stages of AD, and, together with retinal imaging techniques, offers unique opportunities for drug discovery and fundamental research into preclinical AD. [ABSTRACT FROM AUTHOR]

Purpose: To analyze changes in the levels of angiogenic and inflammatory cytokines following the administration of intravitreal conbercept (IVC) or intravitreal ranibizumab (IVR) in patients with macular edema (ME) due to central retinal vein occlusion (CRVO). Methods: This retrospective study was conducted between June 2015 and January 2016 in The First Hospital of China Medical University. We administered 3 consecutive monthly doses of IVC (23 eyes) or IVR (19 eyes) in 42 eyes with CRVO-ME. At each injection, we collected aqueous humor samples and used multiplex bead assays to measure 7 angiogenic and inflammatory cytokines [vascular endothelial growth factor (VEGF), placental growth factor (PlGF), platelet-derived growth factor (PDGF)-AA, monocyte chemoattractant protein (MCP)-1, and interleukins (ILs)-6, 8, and 12]. Results: Visual acuity and ME improved significantly in both groups during the treatment period. Compared with the baseline, all the cytokine concentrations in the aqueous humor samples decreased significantly at 1 and 2 months after the initial dose of IVC or IVR. The improvement of visual acuity and ME and the changes of aqueous humor cytokine levels were similar in both groups. Concentrations of VEGF, PlGF, MCP-1, PDGF-AA, IL-6, IL-8, and IL-12 levels did not show significant intergroup differences after 1 month (P = 0.369, 0.312, 0.185, 0.353, 0.135, 0.487, and 0.337, respectively) and 2 months (P = 0.305, 0.376, 0.230, 0.519, 0.114, 0.960, and 0.830, respectively) of follow-up. Conclusion: IVC and IVR induced comparable improvements in clinical parameters, along with equivalent reductions in the concentrations of angiogenic and inflammatory cytokines in the aqueous humor. [ABSTRACT FROM AUTHOR]

The study aimed to assess the effect and mechanism of safflower injection in preventing retinal vein thrombosis in rabbits. Twenty healthy adult pigmented rabbits were randomly assigned to either the experimental group, receiving safflower injection, or the control group, receiving normal saline. After two weeks of treatment, blood samples were collected to analyze platelet adhesion and aggregation rates. Photodynamic therapy was applied to induce occlusion in the target retinal vein. Fundus photography and fluorescein angiography were recorded using a dynamic microscopic monitoring system, and laser speckle imaging was employed to assess blood flow in the affected vein. The experimental group exhibited significantly lower rates of platelet adhesion and aggregation compared to the control group. Following the induction of retinal vein occlusion, the experimental group showed a lower complete occlusion rate of the target retinal vein. Although initial blood flow in the target vein was similar between groups, the blood flow at 1, 3, and 5 min post-occlusion was significantly higher in the experimental group. Safflower injection delayed retinal vein thrombosis formation, preserved blood flow in the affected retinal area, and reduced platelet adhesion and aggregation. These effects facilitated vascular reperfusion within a limited timeframe., (© 2024. The Author(s).)

Retinal arteriovenous nicking (AVN) manifests as a reduced venular caliber of an arteriovenous crossing. AVNs are signs of many systemic, particularly cardiovascular diseases. Studies have shown that people with AVN are twice as likely to have a stroke. However, AVN classification faces two challenges. One is the lack of data, especially AVNs compared to the normal arteriovenous (AV) crossings. The other is the significant intra-class variations and minute inter-class differences. AVNs may look different in shape, scale, pose, and color. On the other hand, the AVN could be different from the normal AV crossing only by slight thinning of the vein. To address these challenges, first, we develop a data synthesis method to generate AV crossings, including normal and AVNs. Second, to mitigate the domain shift between the synthetic and real data, an edge-guided unsupervised domain adaptation network is designed to guide the transfer of domain invariant information. Third, a semantic contrastive learning branch (SCLB) is introduced and a set of semantically related images, as a semantic triplet, are input to the network simultaneously to guide the network to focus on the subtle differences in venular width and to ignore the differences in appearance. These strategies effectively mitigate the lack of data, domain shift between synthetic and real data, and significant intra- but minute inter-class differences. Extensive experiments have been performed to demonstrate the outstanding performance of the proposed method.

Background: Leptin is a vasoactive peptide that has been linked to diseases associated with macrovascular deterioration. What is still uncertain is its involvement in the microvasculature. Since microvascular changes are presumed to precede macrovascular deterioration, we examined whether measures of the retinal microvasculature are associated with leptin in healthy, young Black and White individuals.Method: We included 283 Black and 289 White men and women (aged 20-30 years). We determined serum leptin, calculated central retinal artery and vein equivalents and arterio-venous ratio. We also measured retinal vessel responses to light flicker provocation.Results: Black men were leaner and had lower leptin than White men, whereas Black women had increased adiposity and leptin compared to White women (all p<0.001). Black groups had narrower retinal arteries, and greater maximum arteriolar and venular dilations in response to light flicker than the White groups (p<0.001). Arterio-venous ratio associated negatively with leptin (all p≤0.044) in all groups (except Black women), but was lost upon adjustment for body mass index and other covariates. We found an inverse association between maximal venular dilation and leptin only in Black men in single and multiple regression analyses (Std β= -0.22; R2=0.05; p=0.035). No associations were found between other retinal measures with leptin in the other groups.Conclusion: We found an independent, negative association between retinal vein dilation with leptin in healthy, young Black men, suggesting a potential detrimental role for leptin in regulating microvascular responses in a population group known to be at greater risk of cardiovascular disease development. [ABSTRACT FROM AUTHOR]

We examined cross-sectional associations of sleep measures with central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) and investigated whether sex and race/ethnicity modified these associations. Participants (N = 202; 78% white; 71% men) were enrolled in the Buffalo Cardio-metabolic Occupational Police Stress study (2011–2014). Wrist actigraphy was used to assess sleep measures including sleep duration, sleep efficiency, sleep onset latency, wake after sleep onset, number of awakenings, and longest wake episode. CRAE and CRVE were obtained from fundus photography of retina and were averaged from both eyes per officer. We observed significant associations between sleep efficiency and CRVE (β = -2.81 µm; P=.046), and between longest wake episode and CRVE (β = 3.24 µm; P=.021). Adjustments for demographics, lifestyles, and physical and psychological factors attenuated these associations. Sex modified the independent associations of sleep onset latency and longest wake episode with CRVE. One standard deviation (SD) increase in sleep onset latency was associated with 4.81 µm larger CRVE (P=.028) (P-interaction = 0.098), and one SD increase in longest wake episode was associated with 4.62 µm larger CRVE (P=.032) (P-interaction = 0.115) among men. Race/ethnicity also modified the association between longest wake episode and CRVE (P-interaction = 0.088). A significant association was observed only among white officers (β = 4.96 µm; P=.025). We found that poor sleep quality, measured by longest wake episode, was positively and independently associated with retinal venular diameter among white and male officers. Longitudinal studies are warranted to assess whether poor sleep quality is a risk factor for retinal diameter changes. [ABSTRACT FROM AUTHOR]

APS was known before the development of CAPS in four patients and was newly diagnosed in one. In-Hospital mortality-associated factors in patients with thrombotic antiphospholipid syndrome requiring ICU admission. Keywords: eculizumab; complement; catastrophic antiphospholipid syndrome; platelets; thrombosis EN eculizumab complement catastrophic antiphospholipid syndrome platelets thrombosis e12 e14 3 01/17/22 20220115 NES 220115 The role of complement activation in catastrophic antiphospholipid syndrome (CAPS) has recently emerged owing to the detection of genetic variations in the proteins of the alternative complement pathway in a subset of patients,1 the protective effect of C5 deficiency in mouse models of CAPS,2 and the anecdotal reports of thrombotic microangiopathy reversal in patients with refractory CAPS and receiving the C5 inhibitor eculizumab as salvage therapy.3 Because CAPS is a very rare condition, optimal therapeutic management remains elusive and the role of eculizumab beyond the conventional triple regimen including unfractionated heparin, glucocorticoids (GCs) and plasma exchanges (PEx) is still debated.4 Yelnik I et al i .5 reported a series of 11 patients with severe CAPS who received eculizumab as salvage therapy after a median (range) delay of 25 (3-100) days. [Extracted from the article]

In this case, the multimodal imaging workup of a unilateral macular oedema in a young woman showed a macular branch retinal vein occlusion as the cause and revealed a closely associated deep ODD conglomerate that was not detected by biomicroscopy. GRAPH: Video S1 (3:14 minutes, 106 MB) Aligned sequence of the corresponding images of the branch retinal vein occlusion in relation to a deep optic disc drusen conglomerate by multimodal imaging and visualization of OCT imaging data by animated three-dimensional rendering. [Extracted from the article]

Robot-assisted retinal cannulation is an eye surgical procedure which can dissolve the obstruction by using robot to inject anticoagulant into occluded vessel. The current research on the critical parameters of cannulation for human is scarce because of the immature technology. Considering the influence of microneedle, this work investigated the effects of drug concentration, injection velocity, injection position, and size of clot on cannulation by theoretical analysis and finite element analysis. For finite element analysis, the multiphysics continuum model was established to demonstrate species transport and reaction which simulates the entire lytic process of the occlusive clot, and four cell zones were established to describe the generation of plasmin (PLS) with the addition of tissue-type plasminogen activator (tPA) and fibrinolysis of clot by importing subroutines into each cell zone under the conditions of constant clot size and variable size, respectively. The results imply that the most efficient value of tPA concentration is 50 nM, injection velocity is 60 mm/s for clot length of 0.1 mm, and the best position to insert the cannula is 0.5 mm in front of the thrombus. For different clot lengths of 0.1 mm to 0.6 mm, the optimal range of tPA concentration and injection velocity is from 20 nM to 70 nM and from 40 mm/s to 60 mm/s, respectively, and explores the reasonable injection position of 0.3 mm to 0.5 mm in front of clot in a vein of 100 μm. This conclusion can be used to perform robot-assisted cannulation surgery to improve fibrinolytic efficiency. [ABSTRACT FROM AUTHOR]

This study aims to investigate the changes in metamorphopsia after administering the treat-and-extend regimen of anti-vascular endothelial growth factor therapy for branch retinal vein occlusion-associated macular edema. We retrospectively examined 27 patients (27 eyes) with macula edema due to branch retinal vein occlusion who received intravitreal injections of anti-vascular endothelial growth factor agents using the treat-and-extend regimen for ≥18 months. We evaluated best-corrected visual acuity, central macular thickness, macular edema recurrence, and amount of metamorphopsia quantified by M-CHARTS. The best-corrected visual acuity (logarithm of minimum angle of resolution) and central macular thickness significantly improved at 18 months compared to baseline, the median value (interquartile range [IQR]), 0.30 (0.15–0.52) and 459 (373–542) μm at baseline, and 0 (-0.08–0.16) and 267 (232–306) μm at 18 months. The M-CHARTS score (the mean of vertical and horizontal scores) significantly decreased at 1, 6, and 12 months compared to baseline, but worsened at 18 month, the median value (IQR), 0.45 (0.250–0.925), 0.4 (0.15–0.70), 0.4 (0.150–0.625), 0.4 (0.225–0.550) and 0.45 (0.225–0.750) at baseline, 1 month, 6 months, 12 months and 18 months, respectively. The median cumulative number of macular edema recurrences was 2 (IQR, 0.5–3.0) at 18 months. Simple linear regression and multivariate analyses revealed that the change in the mean M-CHARTS score at 18 months was significantly correlated with the baseline score and the cumulative number of macular edema recurrences. Anti-vascular endothelial growth factor therapy using the treat-and-extend regimen improved metamorphopsia in branch retinal vein occlusion-related macular edema in the short to mid-term follow-up period, but not in the long term. Macular edema recurrence may be associated with persistent metamorphopsia. [ABSTRACT FROM AUTHOR]

We investigated the characteristics of microvessel tortuosity in branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO) and their associations with visual outcomes using optical coherence tomography angiography (OCTA). Thirty-four BRVO and 21 CRVO patients and 31 healthy subjects were included. From OCTA, the branch number (BN), mean branch length (BL), mean Euclidean length (EL), vessel density (VD) and vessel tortuosity (VT) were quantified. In BRVO eyes, compared with that in the controls, the affected area of the deep capillary plexus (DCP) showed a decreased BN and VD, an increased BL, and unchanged VT. The nonaffected area of the DCP showed decreases in BN, VD and VT. The affected area of the superficial capillary plexus (SCP) showed higher VT. In CRVO eyes, the DCP showed a lower BN, VD and VT, while the SCP showed a lower BN and greater BL and EL. Improved visual acuity (VA) after 1 year in BRVO eyes was associated with decreases in BN, BL, VD and VT in the affected area in the DCP and lower VT in the nonaffected area of the SCP; in CRVO eyes, improved VA was associated with a higher BL and EL in the DCP. VT, BL, and EL may be new microvascular markers associated with changes in VA in BRVO and CRVO. [ABSTRACT FROM AUTHOR]

Retinal vessel segmentation has high value for the research on the diagnosis of diabetic retinopathy, hypertension, and cardiovascular and cerebrovascular diseases. Most methods based on deep convolutional neural networks (DCNN) do not have large receptive fields or rich spatial information and cannot capture global context information of the larger areas. Therefore, it is difficult to identify the lesion area, and the segmentation efficiency is poor. This paper presents a butterfly fully convolutional neural network (BFCN). First, in view of the low contrast between blood vessels and the background in retinal blood vessel images, this paper uses automatic color enhancement (ACE) technology to increase the contrast between blood vessels and the background. Second, using the multiscale information extraction (MSIE) module in the backbone network can capture the global contextual information in a larger area to reduce the loss of feature information. At the same time, using the transfer layer (T_Layer) can not only alleviate gradient vanishing problem and repair the information loss in the downsampling process but also obtain rich spatial information. Finally, for the first time in the paper, the segmentation image is postprocessed, and the Laplacian sharpening method is used to improve the accuracy of vessel segmentation. The method mentioned in this paper has been verified by the DRIVE, STARE, and CHASE datasets, with the accuracy of 0.9627, 0.9735, and 0.9688, respectively. [ABSTRACT FROM AUTHOR]

Retinal image contains rich information on the blood vessel and is highly related to vascular diseases. Fully automatic and accurate identification of arteries and veins from the complex background of retinal images is essential for analyzing eye-relevant diseases, and monitoring progressive eye diseases. However, popular methods, including deep learning-based models, performed unsatisfactorily in preserving the connectivity of both the arteries and veins. The results were shown to be disconnected or overlapped by the twos and thus manual calibration was needed to refine the results. To tackle the problem, this paper proposes a topological structure-constrained generative adversarial network (topGAN) to automatically identify and differentiate the arteries and veins from retinal images. The introduced topological structure term can automatically delineate the topological structure properties of retinal blood vessels and greatly improves the vascular connectivity of the entire arteriovenous classification results. We train and evaluate our model on both the AV-DRIVE public available dataset and the CVDG home-owned dataset, which consists of 40 images and 3119 images, respectively. Experiments demonstrate that integrating topological structure constraints can significantly improve the performance of arteriovenous classification. Our method achieves excellent performance with an accuracy of 94.3% on the AV-DRIVE dataset and 93.6% on the CVDG dataset. [ABSTRACT FROM AUTHOR]

Purpose: Existing research suggests that changes to retinal vascular caliber reflect nitric oxide (NO)-dependent endothelial dysfunction. Dietary nitrate is an important source of NO; however, studies on the link between dietary nitrate intake and retinal microvasculature are lacking. We aimed to assess the cross-sectional association between intake of dietary nitrate (from vegetable and non-vegetable sources) and retinal arteriolar and venular caliber among older adults. Methods: Participants from the Blue Mountains Eye Study aged 49+ years with complete data at baseline on diet and retinal vessel measures were analyzed (n = 2813). Dietary intake was assessed using a validated semi-quantitative food-frequency questionnaire. Nitrate intake from vegetable and non-vegetable sources was estimated using a validated comprehensive database and other published data where necessary. Fundus photographs were taken and retinal vascular caliber measured using validated computer-assisted techniques and summarized. Results: Participants in the lowest versus highest tertile of vegetable nitrate intake had significantly narrower retinal arterioles: 186.2 ± 0.48 versus 187.6 ± 0.48 µm (multivariable-adjusted p = 0.04). After multivariable adjustment, each 10-unit higher intake of total nitrate and vegetable nitrate was associated with 0.089 ± 0.004 and 0.090 ± 0.004 µm wider retinal arteriolar caliber, respectively, both p = 0.03. Each 10-unit higher vegetable nitrate intake was associated with 0.092 ± 0.005 µm narrower retinal venules (p = 0.05). Conclusion: Intake of dietary nitrate, particularly from vegetable sources, was associated with beneficial variations in both retinal arteriolar and venular caliber among older adults. Further research into associations between dietary nitrate and the retinal microvasculature could allow for greater understanding and possible prevention of clinical cardiovascular events. [ABSTRACT FROM AUTHOR]

Since morphology of retinal blood vessels plays a key role in ophthalmological disease diagnosis, retinal vessel segmentation is an indispensable step for the screening and diagnosis of retinal diseases with fundus images. In this paper, deep convolution adversarial network combined with short connection and dense block is proposed to separate blood vessels from fundus image, named SUD-GAN. The generator adopts U-shape encode-decode structure and adds short connection block between convolution layers to prevent gradient dispersion caused by deep convolution network. The discriminator is all composed of convolution block, and dense connection structure is added to the middle part of the convolution network to strengthen the spread of features and enhance the network discrimination ability. The proposed method is evaluated on two publicly available databases, the DRIVE and STARE. The results show that the proposed method outperforms the state-of-the-art performance in sensitivity and specificity, which were 0.8340 and 0.9820, and 0.8334 and 0.9897 respectively on DRIVE and STARE, and can detect more tiny vessels and locate the edge of blood vessels more accurately. [ABSTRACT FROM AUTHOR]

The tortuosity changes of curvilinear anatomical organs such as nerve fibers or vessels have a close relationship with a number of diseases. Therefore, the automatic estimation and representation of the tortuosity is desired in medical image for such organs. In this paper, an automated framework for tortuosity estimation is proposed for corneal nerve and retinal vessel images. First, the weighted local phase tensor-based enhancement method is employed and the curvilinear structure is extracted from raw image. For each curvilinear structure with a different position and orientation, the curvature is measured by the exponential curvature estimation in the 3D space. Then, the tortuosity of an image is calculated as the weighted average of all the curvilinear structures. Our proposed framework has been evaluated on two corneal nerve fiber datasets and one retinal vessel dataset. Experiments on three curvilinear organ datasets demonstrate that our proposed tortuosity estimation method achieves a promising performance compared with other state-of-the-art methods in terms of accuracy and generality. In our nerve fiber dataset, the method achieved overall accuray of 0.820, and 0.734, 0.881 for sensitivity and specificity, respectively. The proposed method also achieved Spearman correlation scores 0.945 and 0.868 correlated with tortuosity grading ground truth for arteries and veins in the retinal vessel dataset. Furthermore, the manual labeled 403 corneal nerve fiber images with different levels of tortuosity, and all of them are also released for public access for further research. [ABSTRACT FROM AUTHOR]

Purpose. To evaluate the effects of intravitreal ranibizumab (IVR) treatment on the blood flow of the optic nerve head (ONH) and of retinal vessels of the peripapillary region of eyes with diabetic macular edema (DME) assessed using laser speckle flowgraphy (LSFG). Methods. Forty eyes of 30 patients treated with IVR for DME were included in this prospective clinical study. Mean blur rate (MBR) and relative flow volume (RFV) of the ONH and of a superior retinal artery and an inferior retinal vein of the peripapillary region were measured using LSFG at baseline, 2 weeks (T1), and 1 month (T2) after IVR injection. In addition, best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were measured in all cases. Results. The BCVA improved and CRT decreased significantly during the follow-up period (p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p = 0.046 ; MT, p = 0.023 ; MV, p = 0.025), with no significant change at T2 compared to T1. MBR of the retinal artery and vein changed significantly at 2 weeks after IVR and did not change significantly thereafter (p = 0.004 and p = 0.01 , respectively). The median of RFV of the 2 vessels was 269.5 (221.6–285.5) and 306.8 (285.6–372.4) at baseline and 199.7 (152.4–204.7) and 259.1 (140.9–336.8) at 4 weeks, respectively (p = 0.292 and p = 0.002 , respectively). Blowout time changed significantly in ONH from 47.6 (44.2–50.2) at baseline to 54.4 (46.8–65.3) at 1 month after IVR (p = 0.001). Conclusion. IVR injection leads to a reduction of ocular blood flow both in the ONH and in the retinal peripapillary vessels associated with peripapillary vessel constriction. The reduction of CRT and related improvement of vision may be related to the changes in ocular blood flow. [ABSTRACT FROM AUTHOR]

Objective: To evaluate functional and anatomical changes in branch retinal vein occlusion (BRVO) up to 3 months in early referral BCVA cases. Method: Twenty-three eyes of 23 consecutive BRVO patients diagnosed within 4 weeks of symptom onset were enrolled in this prospective, observational study. Eyes were followed up without treatment. Measurements in best corrected visual acuity (BCVA) and central macular thickness (CMT) at the baseline, 2 weeks, 1 month and 3 months were evaluated. Results: The improvement in mean BCVA from the baseline to 2 weeks (p=0.043), 1 month (p=0.012) and 3 months was found statistically significant (p=0.001). Despite a decrease in central macular thickness (CMT) was observed, the change in CMT from the baseline to 3 months did not reach a clinical significance (p=0.068). Conclusion: Considering the natural course in BRVO, follow-up without treatment may also be acceptable up to the first 3 months. Our results indicate that delaying treatment up to 3 months is not associated with increased CMT or deteriorated BCVA for recent onset early referral BRVO cases. [ABSTRACT FROM AUTHOR]

Diabetic retinopathy (DR) is a sight-threatening complication of diabetes. This study investigated the therapeutic effect of probucol in a mouse model of diabetic retinopathy. C57BL/6 mice were rendered diabetic through Streptozotocin (STZ) intraperitoneal injection. Mice were treated with probucol (150 mg/kg, gavage administration) or vehicle (DMSO) for 12 weeks. Optical coherence tomography (OCT), fundus photography (FP), and fundus fluorescein angiography (FFA) were conducted to evaluate retinal structure and damage. Eyes were collected for histology, reactive oxygen species (ROS) assay, apoptotic cells count, and western blot. After STZ injection, all mice developed hyperglycemia. Compared with the retina of the control group, the retina of diabetic mice showed enhanced arterial reflex and beaded vein dilatation. Besides, reduced inner and middle retinal thickness and significantly fewer nuclei were found in diabetic retina. Moreover, the diabetic retina also presented increased ROS generation and more TUNEL-positive cells. Probucol treatment prevented diabetes-induced lesions. In addition, the treatment also upregulated Nrf2 expression in diabetic retina. It was suggested that probucol attenuated diabetes-induced retinal neuronal degeneration via upregulating the Nrf2 signaling pathway possibly. Probucol may be repurposed for DR management. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the thinning of central choroidal thickness (CCT) following intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) drugs to treat central retinal vein occlusion (CRVO)-related macular edema in patients with and without systemic hypertension (HT) to assess the influence of repeated anti-VEGF therapy and HT on the choroid in CRVO eyes. Methods: We conducted a retrospective study involving 27 patients with CRVO-related macular edema from January 2014 to July 2017, with follow-ups exceeding 18 months. Visual acuity (VA), central retinal thickness (CRT), and CCT were evaluated before and after initial anti-VEGF drug treatment during follow-up. Results: The mean follow-up period was 35.2 months. Seventeen (63.0%) patients had HT. At 1 month after treatment, VA had improved in 21 (77.8%) patients, and CRT had decreased in 25 (92.6%). At the final visit, 22 (81.5%) showed improved VA, 19 (70.4%) had resolved macular edema, and the CCT had gradually become thinner with additional drug injections in all the patients. Furthermore, the mean CCT in HT patients (209.0 µm) was significantly lower than in non-HT patients (256.1 µm), and the mean injections were 7.8 and 5.3, respectively (p = 0.2067). Conclusion: The CCTs were thinner in eyes with HT than in eyes without HT both before and after the repeated anti-VEGF injections. [ABSTRACT FROM AUTHOR]

Aims/Purpose: Neurovascular dysfunction and inner retinal layer thinning are among the earliest detectable retinal changes in diabetes, and both worsen during development and progression of diabetic retinopathy (DR). However, direct interactions between these features have not been investigated so far. Therefore, we aimed to analyse associations between the retinal functional hyperaemic response and thickness of the individual neuroretinal layers in eyes with non‐proliferative DR. Methods: Thirty patients with Type 1 diabetes featuring mild (n = 15) or moderate (n = 15) non‐proliferative DR and 14 healthy subjects were included in this cross‐sectional study. Retinal vessel diameters were measured before and during illumination with flickering light using a dynamic vessel analyser. Individual retinal layer thickness in the macula was analysed from spectral domain optical coherence tomography. Results: Flicker light‐induced vessel dilation was significantly reduced in diabetes patients compared to healthy controls (veins: 3.0% vs. 6.1%, p < 0.001; arteries: 1.3% vs. 5.1%, p = 0.005). Univariately, the response in retinal veins of diabetes patients correlated significantly with ganglion cell layer (GCL) thickness (r = 0.46, p = 0.010) and inner plexiform layer thickness (r = 0.40, p = 0.027), and negatively with haemoglobin A1c (HbA1c) levels (r = −0.41, p = 0.023) and age (r = −0.38, p = 0.037), but not with baseline diameters, glucose levels, or diabetes duration. In a multiple regression model only HbA1c (p = 0.027, β = −0.40) and GCL thickness (p = 0.030, β = 0.39) remained significantly associated with the vascular flicker light response. Conclusions: The results indicate that thinner GCL and worse glycaemic control both contribute to reduced neurovascular coupling in patients with clinical signs of DR. Progression of neurovascular dysfunction in DR might be related to structural degeneration of the neurovascular complex in the inner retina. [ABSTRACT FROM AUTHOR]

Aims/Purpose: Branch retinal vein occlusion (BRVO) occurs when a branch of the retinal vein becomes obstructed. The aim of this study case was to provide insights into the potential role of Lipoprotein (Lp) (a) in the pathogenesis of BRVO. Methods: Case of a 47‐year‐old woman with no significant ophthalmological or general medical history, except the use of oral contraception and smoking habits. Presented to the emergency care after 5 days of experiencing a sudden vision loss in her right eye. Results: The ophthalmological examination revealed a visual acuity of 10/10 on the left (OS) and VBLM/10 on the right eye (OD). Slit lamp and Fundus examination showed on OD a relative afferent pupillary defect and the classic features of acute retinal branch vein occlusion, including tortuous veins, capillary occlusion, papillary and macular oedema and haemorrhages. While all was normal in OS. A comprehensive ophthalmic examination was conducted, including fluorescein angiography and optical coherent tomography that showed no abnormal vessel growth at this stage. Then, the indication for a dexamethasone intravitreal implant has been made along with panretinal photocoagulation (PRP) in the ischaemic areas. More, discontinuing oral contraception, the serum concentrations of specific antibodies, as anticardiolipin and antiphospholipids, as well as homocysteine and Lp (a) levels. The blood tests yielded negative results except for the abnormal plasma level of lipoprotein (a), which was measured at 900 mg/L. After 2 months of follow‐up. The visual acuity in OD was measured at 9/10. Moreover, the restoration of normal macular thickness after 4 months. However, at 6 months follow‐up, the appearance of a neovascularization adjacent to the previously laser‐treated area. As a result, a series of closely spaced PRP was performed along with an intravitreal anti‐vascular endothelial growth factor. After 1 month, a complete disappearance of the neovascularization was observed. Conclusions: Identification of independent and highly predictive risk factors for BRVO is still a big challenge. The main goals are the preservation of visual acuity and the prevention of relapses. This case report emphasizes the importance of incorporating a systematic Lp (a) testing into clinical practice, even in young individual. [ABSTRACT FROM AUTHOR]

Aims/Purpose: We present a rare case of a patient who presented with bilateral retinal haemorrhage after cardiopulmonary resuscitation (CPR). Methods: A 37‐year‐old man, with a medical history of allergic bronchial asthma and a BMI >35, was referred to our emergency department from the cardiology clinic. He complained of sudden, painless, monocular visual acuity reduction after cardiac arrest and CPR because of an acute myocardial infarction (right coronary). He underwent a complete ophthalmic examination, as well as multimodal imaging and he was under close monitoring for the following months. Results: In his initial ophthalmic examination, best corrected visual acuity was 0.1 in his right eye and 1.0 in his left eye (Snellen's chart). Intraocular pressure was 14 mmHg and 15 mmHg in his right and left eye, respectively. Dilated fundus examination showed bilaterally scattered sub‐retinal, intraretinal and pre‐retinal haemorrhages in the posterior pole, with involvement of the right fovea. After the resolution of the haemorrhages, a fluoroangiography was performed which revealed delayed central retinal vein filling in the right eye. 2 months later, during follow‐up examination, visual acuity in the right eye was 0.7 and in the left eye 1.0. The haemorrhages have been absorbed bilaterally, leaving in the right eye a sub‐foveal photoreceptor and RPE disruption. Conclusions: Retinal haemorrhages can be observed after CPR. According to the literature, there have been reports of retinal haemorrhages in infants after CPR. Meanwhile, there is only one published case of an adult with associated comorbidities with this clinical presentation. The underlying pathophysiology of this clinical entity is still unclear, although a potential relationship between the increase in central venous pressure during CPR, and sequential retinal venous stasis is suspected. [ABSTRACT FROM AUTHOR]

Aims/Purpose: This cohort study investigates how the static and dynamic vessel parameters differ in patients with vascular occlusions and if there are any variations between the different types of vessel occlusion. Methods: Patients with the diagnosis of branch retinal artery obstruction BRAO, central retinal artery obstruction CRAO, branch retinal vein obstruction BRVO, central retinal vein obstruction CRVO, anterior ischaemic optic neuropathy AION and any combination of these Combo were included in our study. During their inpatient stay for cardiovascular diagnostics all patients were examined via static and dynamic vessel analysis (IMEDOS Health GmbH, Jena) to obtain the arteriovenous ratio (AVR), the central retinal artery equivalent (CRAE), the central retinal vein equivalent (CRVE) and the flicker light induced dilation of the retinal arteries (FLA) and veins (FLV). The vessel density was determined via OCT angiography (Heidelberg Engineering GmbH, Heidelberg). Results: 34 patients (70% male; 30% female; mean age 69.6 ± 11.3 years) with 9 (26.5%) CRVO, 8 (23.5%) AION, 5 (14.7%) BRAO and 4 (11.8%) CRAO, BRVO and Combo each have been included. The best visual acuity (BCVA) of the diseased eye differed significantly between the groups (AION 0.41 ± 0.61, CRAO 2.40 ± 0.20, BRAO 0.16 ± 0.05, CRVO 0.81 ± 0.86, BRVO 0.18 ± 0.10, Combo 1.53 ± 0.68; p < 0.001) whereas the BCVA of the healthy eyes were comparable. The CRVE showed a significant difference between the groups CRAO – CRVO (p = 0.008), CRAO – Combo (p < 0.001) and BRAO–Combo (p = 0.026). The FLV of the diseased eye was significantly higher in patients with AION than in the CRAO group (p = 0.049). The parameters of the static vessel analysis of the healthy eyes were comparable. Conclusions: Preliminary analysis shows significant differences of individual parameters of the retinal vessel analysis between different types of vascular occlusion. The diagnostic and research benefit for the individual patient remains to be further evaluated. [ABSTRACT FROM AUTHOR]