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Date of download: 5/27/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Correlation of Increased Vascular Endothelial Growth.

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Presentation on theme: "Date of download: 5/27/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Correlation of Increased Vascular Endothelial Growth."— Presentation transcript:

1 Date of download: 5/27/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Correlation of Increased Vascular Endothelial Growth Factor With Neovascularization and Permeability in Ischemic Central Vein Occlusion Arch Ophthalmol. 2002;120(12):1644-1650. doi:10.1001/archopht.120.12.1644 Patient groups. NVI indicates neovascularization of the iris; PRP, panretinal photocoagulation. Figure Legend:

2 Date of download: 5/27/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Correlation of Increased Vascular Endothelial Growth Factor With Neovascularization and Permeability in Ischemic Central Vein Occlusion Arch Ophthalmol. 2002;120(12):1644-1650. doi:10.1001/archopht.120.12.1644 Baseline retinal nonperfusion measured in disc areas on fluorescein angiography in relation to initial aqueous vascular endothelial growth factor (VEGF) level. There was a strong correlation(Spearman ρ = 0.72, P<.01). Figure Legend:

3 Date of download: 5/27/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Correlation of Increased Vascular Endothelial Growth Factor With Neovascularization and Permeability in Ischemic Central Vein Occlusion Arch Ophthalmol. 2002;120(12):1644-1650. doi:10.1001/archopht.120.12.1644 Aqueous vascular endothelial growth factor (VEGF) concentrations by outcome group. Patients in outcome group 1 did not develop neovascularization of the iris (NVI) and had low final aqueous VEGF concentrations after an initial mild elevation. Patients in outcome group 2 showed increasing aqueous VEGF levels before NVI and reached a mean threshold concentration of 1201 pg/mL at the time of clinically evident NVI. Patients in outcome group 3 had a mean aqueous VEGF level of 189 pg/mL, with an upper limit of 550 pg/mL (solid line A), with full regression of NVI after panretinal photocoagulation. Patients in outcome group 4 had persistent NVI despite extensive panretinal photocoagulation and a mean aqueous VEGF level of 1295 pg/mL. iCRVO indicates ischemic central retinal vein occlusion. Figure Legend:

4 Date of download: 5/27/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Correlation of Increased Vascular Endothelial Growth Factor With Neovascularization and Permeability in Ischemic Central Vein Occlusion Arch Ophthalmol. 2002;120(12):1644-1650. doi:10.1001/archopht.120.12.1644 Clinical findings in a representative patient from each outcome group. A-D, Outcome group 1. A and C, Normal clinical appearance of iris at 3 and 30 weeks after onset of ischemic central retinal vein occlusion (iCRVO). B, At 3 weeks the iris angiogram was normal with no vessel leakage. D, An initially mild elevation of aqueous vascular endothelial growth factor (VEGF) spontaneously decreased. E-H, Outcome group 2. E, Normal iris at 10 weeks before onset of neovascularization of the iris (NVI). F and G, First clinical evidence of NVI (arrow) and corresponding iris angiogram showing leakage from neovascularization. H, Aqueous VEGF shows an apparent plateau of approximately 1100 pg/mL before onset of NVI. I-L, Outcome group 3. I and J, Extensive NVI at presentation (arrows) confirmed by leakage on iris angiography. K, Minimal leakage on iris angiography following full regression of NVI after panretinal photocoagulation. L, Steady decrease in aqueous VEGF coincided with full regression of NVI. M-P, Outcome group 4. M and N, Very extensive NVI at presentation (arrows) confirmed by massive leakage on iris angiography. O, Persistent iris neovascularization (arrows) despite extensive panretinal photocoagulation. P, Aqueous VEGF initially decreased after panretinal photocoagulation but rose again thereafter. Figure Legend:

5 Date of download: 5/27/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Correlation of Increased Vascular Endothelial Growth Factor With Neovascularization and Permeability in Ischemic Central Vein Occlusion Arch Ophthalmol. 2002;120(12):1644-1650. doi:10.1001/archopht.120.12.1644 Capillary zone electrophoresis of aqueous humor and serum albumin. A, Normal aqueous fluid. B, Pure serum albumin. C, Normal aqueous fluid spiked with serum albumin. The retention time for the albumin peak is 4.5 minutes. Figure Legend:

6 Date of download: 5/27/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Correlation of Increased Vascular Endothelial Growth Factor With Neovascularization and Permeability in Ischemic Central Vein Occlusion Arch Ophthalmol. 2002;120(12):1644-1650. doi:10.1001/archopht.120.12.1644 Serum albumin and vascular endothelial growth factor (VEGF) levels in aqueous humor of patients with ischemic central retinal vein occlusion (iCRVO). A, Group 1 patient. A decrease in aqueous albumin level correlated with a decrease in aqueous VEGF concentration. B, Close correlation of aqueous VEGF and albumin concentrations in a patient from groups 2 and 3; note that there is a delay after VEGF concentration increases before albumin increases, probably because of the time it takes for albumin to accumulate in the aqueous humor. PRP indicates panretinal photocoagulation; NVI, neovascularization of the iris. Figure Legend:


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