Retinal arterial and vein occlusion: is surgery ever indicated?

IF 3 2区医学 Q1 OPHTHALMOLOGY

Current Opinion in Ophthalmology Pub Date : 2024-05-01 Epub Date: 2024-02-28 DOI:10.1097/ICU.0000000000001045

Kazuaki Kadonosono, Maiko Inoue, Yasuo Yanagi

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引用次数: 0

Abstract

Purpose of review: To highlight the recent progression in surgical treatments for central retinal vein occlusion (CRVO) and central retinal artery occlusion (CRAO).

Recent findings: Anti-VEGF treatment, accepted as a primary treatment for CRVO, is unable to effectively treat all types of the diseases. Regarding CRAO, there are not any accepted therapies available. There have however been recent innovations in surgery, such as utilizing robotics-assisted tools in cannulation procedures for central retinal artery occlusion, or micro-cystotomy for refractory macular edema resulting from ischemic CRVO.

Summary: Refractory macular edema due to CRVO can be treated with aspiration of the fluid found inside the large cysts often seen in edema. The success rate of micro-cystotomy has been reported at 78% in eyes with refractory macular edema. Recent studies have shown that cannulation with tissue plasminogen activator (tPA) is effective for eyes with CRAO due to thrombus.Recent cannulation or micro-cystotomy procedures can be enhanced with the use of robotic tools which allow us to perform this difficult procedure more easily. Newly developed technology, and consequent developments in surgical procedures, will allow us to deal with unmet needs for retinal vessel occlusive diseases.

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视网膜动静脉闭塞：是否需要手术？

综述目的：重点介绍视网膜中央静脉闭塞（CRVO）和视网膜中央动脉闭塞（CRAO）手术治疗的最新进展：最新发现：抗血管内皮生长因子治疗被认为是治疗 CRVO 的主要方法，但无法有效治疗所有类型的疾病。至于 CRAO，目前还没有任何公认的疗法。不过，最近在手术方面有所创新，例如利用机器人辅助工具进行视网膜中央动脉闭塞的插管手术，或对缺血性 CRVO 引起的难治性黄斑水肿进行微囊切开术：由 CRVO 引起的难治性黄斑水肿可通过抽吸水肿中常见的大囊肿内的液体来治疗。据报道，在患有难治性黄斑水肿的眼睛中，显微囊肿切开术的成功率为78%。最近的研究表明，使用组织纤溶酶原激活剂（tPA）插管对因血栓导致的 CRAO 眼球有效。最近的插管或微囊切开术可通过使用机器人工具得到改进，使我们能更轻松地完成这一高难度手术。新开发的技术以及随之而来的手术程序的发展，将使我们能够应对视网膜血管闭塞疾病方面尚未得到满足的需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Ophthalmology 医学-眼科学

CiteScore

6.80

自引率

5.40%

发文量

120

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Ophthalmology is an indispensable resource featuring key up-to-date and important advances in the field from around the world. With renowned guest editors for each section, every bimonthly issue of Current Opinion in Ophthalmology delivers a fresh insight into topics such as glaucoma, refractive surgery and corneal and external disorders. With ten sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, clinicians and other healthcare professionals alike.