Pathogenetic justification of affected vessel massage using for the retinal vein occlusion treatment (experimental study)

Retinal vein occlusion was described 160 years ago; however, some pathogenesis aspects of the disease remain controversial at present.

The aim – to study the characteristics of the photoinduced retinal vein occlusion with the aim of developing of pathogenetically based method for its treatment.

Material and methods. The experiment was carried out on 60 rabbits. 40 animals were subjected to photoinduced retinal vein occlusion with the «Photoditazine» injection and laser irradiation of blood vessels. The retinal veins massage with the scraper’s silicone tip was made on 20 intact animals. The 40 rabbits with photoinduced retinal vein occlusion were divided into 2 equal groups: the main group, which received massage of the obturated retinal vein, and the comparison group, which were injected with 500 international units (IU) of recombinant prourokinase.

Results. In experimental photoinduced occlusion of retinal veins, the forming thrombus in the vessel caused microcirculation disorders with the development of retinal edema, plasmorrhagias and hemorrhages. Affected retinal vein massage accelerated resorption of retinal edema by1.5 times and accelerated the lysis of hemorrhages by 2.0 times compared with epiretinal fibrinolytic injection, without causing a damaging effect on the vessel. In animals of the main group, according to optical coherence tomography, edema of the retinal central parts decreased by 1.5 times. According to fluorescent angiography, the time of retino-vein perfusion decreased by 2.6 times compared with epiretinal injection of prourokinase.

Conclusions. Experimental studies have confirmed the safety and effectiveness of retinal vein massage for the treatment of occlusion of central retinal vein and its branches. Massage of the retinal veins contributes to the rapid reversal of pathological changes in the retina during mechanical action on the wall of affected vessel with subsequent restoration of its patency. 

1. Libman ES, Kaleeva EV. Complex characteristic of disability due to ophthalmology in the Russian Federation. Russian Ophthalmology. 2012;5:24–26. (In Russ.).

2. Hayreh SS, Zimmerman MB. Ocular neovascularization associated with central and hemicentral retinal vein occlusion. Retina. 2012;32(8):1553–1565.

3. Williamson T. H. A «throttle» mechanism in the central retinal vein in the region of the lamina cribrosa. Br. J. Ophthalmol. 2007;91(12):1190–1193.

4. Petrishchev NN, Vasina LV. Violation of adhesion activity as a form of endothelial dysfunction. Translational medicine. 2014;3(28):5–15. (In Russ.).

5. Dixon SG. Retinal vascular occlusion: a window to diagnosis of familial and acquired thrombophilia and hypofibrinolysis, with important ramifications for pregnancy outcomes. Clin. Ophthalmol. 2016;10:1479–1486.

6. Ip M, Hendrick A. Retinal vein occlusion: review. Asia Pac. J. Ophthalmol. 2018;7(1):40–45.

7. Bely YuA, Tereshchenko AV, Shatskikh AV et al. Experimental study of the dynamics of immunoexpression of VEGF-factor in retinal tissues on the model of photo-induced thrombosis of the branch of the central retinal vein. Ophthalmology. 2014;11(2):32–38 (In Russ.)]. Doi: 10.18008/1816-5095-2014-2-32-38.

8. Petrachkov DV, Krivosheina OI, Zapuskalov IV, Petrachkov DV, Krivosheina OI, Zapuskalov IV. Our experience in the treatment of thrombosis of the central retinal vein and its branches using epiretinal administration of hemase. Ophthalmic surgery. 2008;4:32–34. (In Russ.).

9. Alkin Z, Kashani AH, Lopez-Jaime GP et al. Quantitative analysis of retinal structures using spectral domain optical coherence tomography in normal rabbits. Current eye research. 2013;38.2:299–304.

10. Sushkevich NG. Pathological systems of hemostasis in thrombophilia. Pathogenesis. 2008;6(4):4–23. (In Russ.).

11. Zapuskalov IV, Krivosheina OI, Khoroshikh YuI. Biomechanics of the «Peripheral Heart» in Eye Tissues. Tomsk: Ivan Fedorov, 2013;140. (In Russ.).

12. Maksimenkova AN. Surgical anatomy of the breast. M.: Medgiz, 1955:196–219. (In Russ.).