Noma Hidetaka, Yasuda Kanako, Shimura Masahiko
Department of Ophthalmology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan.
J Ophthalmol. 2019 May 2;2019:5185128. doi: 10.1155/2019/5185128. eCollection 2019.
Branch retinal vein occlusion (BRVO) is a very common retinal vascular problem in patients with lifestyle-related diseases, such as hypertension and arteriosclerosis. In patients with BRVO, development of macular edema is the main cause of visual impairment. BRVO is still a controversial condition in many respects. Over the years, various methods such as laser photocoagulation have been tried to treat macular edema associated with BRVO, but the results were not satisfactory. After vascular endothelial growth factor (VEGF) was found to have an important role in the pathogenesis of macular edema in BRVO patients, treatment of this condition was revolutionized by development of anti-VEGF therapy. Although macular edema improves dramatically following intraocular injection of anti-VEGF agents, repeated recurrence and resistance of edema is a major problem in some BRVO patients. This suggests that factors or cytokines other than VEGF may be associated with inflammation and retinal hypoxia in BRVO and that the pathogenesis of macular edema is complicated. The present review assesses the role of various factors and cytokines in the pathogenesis of macular edema associated with BRVO. We present a mechanism that is not only plausible but should also be useful for developing new therapeutic strategies.
视网膜分支静脉阻塞（BRVO）是患有与生活方式相关疾病（如高血压和动脉硬化）的患者中非常常见的视网膜血管问题。在BRVO患者中，黄斑水肿的发生是视力损害的主要原因。BRVO在许多方面仍是一个有争议的病症。多年来，人们尝试了各种方法（如激光光凝）来治疗与BRVO相关的黄斑水肿，但结果并不令人满意。在发现血管内皮生长因子（VEGF）在BRVO患者黄斑水肿的发病机制中起重要作用后，抗VEGF疗法的发展彻底改变了这种病症的治疗方式。尽管眼内注射抗VEGF药物后黄斑水肿会显著改善，但在一些BRVO患者中，水肿的反复复发和耐药是一个主要问题。这表明除VEGF外的其他因素或细胞因子可能与BRVO中的炎症和视网膜缺氧有关，并且黄斑水肿的发病机制很复杂。本综述评估了各种因素和细胞因子在与BRVO相关的黄斑水肿发病机制中的作用。我们提出了一种不仅合理而且对开发新治疗策略有用的机制。
