Central retinal vein occlusion: Cetrain risk factors, electroretinography and an experimental treatment model

University dissertation from Dept of Ophthalmology, Lund University Hospital, 221 85 Lund, Sweden

Abstract: The presence of activated protein C resistance, plasma hyperhomocysteinemia and the MTHFR C677T mutation in patients with central retinal vein occlusion were investigated and compared to a control group. Activated protein C resistance was overrepresented in the group of patients less than 50 years of age whereas this was not the case in patients more than 50 years of age. Neither hyperhomocysteinemia nor the MTHFR C677T mutation were more frequently seen in the patients independent of their age compared to the controls. Electroretinography was performed early in the course of central retinal vein occlusion, and was shown to have a good predictability concerning the development of rubeosis. We have also shown that full-field ERG, and especially the b-wave implicit time in the 30 Hz flicker ERG is a better predictor for prognosis than fluorescein angiography in patients with recent central retinal vein occlusion. An experimental model of retinal vein occlusion in the rabbit was developed to investigate if it was possible to lower the dose of streptokinase and retain a good thrombolytic effect by adding pulsed ultrasound. These results show that it is possible to halve the dose of streptokinase and still retain a good thrombolytic effect by adding pulsed ultrasound.

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