医学診断法ジャーナル
オープンアクセス

概要

Clinical Diagnosis in Central Retinal Vein Occlusion

Hidetaka Noma

With unhealthy eating habits and the aging of society, there has been an increase of lifestyle-related diseases such as hypertension, hyperlipidemia, and diabetes, which are important risk factors for central retinal vein occlusion (CRVO).The condition is classified into non-ischemic CRVO and ischemic CRVO, with the ischemic form being associated with an increased risk of neovascularization and having a poor prognosis. Therefore, it is important to differentiate non-ischemic from ischemic CRVO as an initial step of management. However, assessment of retinal ischemia is difficult in the acute phase of CRVO. Examinations of ocular function (visual acuity, visual field tests, relative afferent pupillary defect, and electroretinography) and morphology (ophthalmoscopy, fluorescein angiography, and optical coherence tomography) are employed to differentiate non-ischemic CRVO from ischemic CRVO. Using these functional and morphological examinations, identification of retinal ischemia is not so difficult. If a simple and rapid method of measuring vascular endothelial growth factor (VEGF) in aqueous humor is established, we may not only use this for differentiation between non-ischemic and ischemic CRVO, but also to decide the indications and predict the response to anti-VEGF therapy.