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{"title"=>"No-Reflow Phenomenon in Central Retinal Artery Occlusion: Incidence, Risk Factors, and Clinical Implications", "type"=>"journal", "authors"=>[{"first_name"=>"Seong Joon", "last_name"=>"Ahn"}, {"first_name"=>"Kyu Hyung", "last_name"=>"Park"}, {"first_name"=>"Na-Kyung", "last_name"=>"Ryoo"}, {"first_name"=>"Jeong-Ho", "last_name"=>"Hong"}, {"first_name"=>"Cheolkyu", "last_name"=>"Jung"}, {"first_name"=>"Chang-Hwan", "last_name"=>"Yoon"}, {"first_name"=>"Moon-Ku", "last_name"=>"Han"}, {"first_name"=>"Se Joon", "last_name"=>"Woo"}], "year"=>2015, "source"=>"PLOS ONE", "identifiers"=>{"pmid"=>"26599539", "issn"=>"1932-6203", "doi"=>"10.1371/journal.pone.0142852"}, "id"=>"a1bf305a-fbc0-33a1-b6ca-034ccce7891d", "abstract"=>"PURPOSE: To investigate the incidence and risk factors of the no-reflow phenomenon in central retinal artery occlusion (CRAO) patients and to determine its effects on visual and anatomic outcomes. METHODS: In 102 eyes with CRAO in which arterial recanalization was obtained within 1 week from baseline, fluorescein angiography images obtained at baseline and 1 week were retrospectively reviewed. The no-reflow phenomenon in the retina was defined as macular capillary nonperfusion following arterial recanalization on fluorescein angiographs. We investigated the incidence and risk factors for the no-reflow phenomenon and compared the anatomical and visual outcomes between eyes with and without the phenomenon. RESULTS: Among the 102 CRAO eyes with arterial recanalization, 39 exhibited the no-reflow phenomenon, resulting in an incidence of 38.2%. The incidence among the eyes with treatment-induced and spontaneous recanalization was 43.4% and 15.8%, respectively, and it increased with the CRAO stage. CRAO stage and increased central macular thickness were risk factors for the phenomenon, with an odds ratio of 4.47 [95% confidence interval (CI), 1.19-16.8; P = 0.027] and 1.69 (95% CI, 1.12-2.55; P = 0.012) per 100-mum increase, respectively. The visual outcome was significantly poorer and retinal atrophy and photoreceptor disruption was greater in eyes with the no-reflow phenomenon than in those without. CONCLUSIONS: The no-reflow phenomenon may occur after arterial recanalization in approximately one-third of CRAO patients and can affect anatomical and visual outcomes. This phenomenon may provide an additional explanation regarding the permanent retinal damage and vision loss in eyes with CRAO.", "link"=>"http://www.mendeley.com/research/noreflow-phenomenon-central-retinal-artery-occlusion-incidence-risk-factors-clinical-implications-3", "reader_count"=>7, "reader_count_by_academic_status"=>{"Student > Doctoral Student"=>1, "Researcher"=>1, "Other"=>2, "Student > Bachelor"=>2, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_user_role"=>{"Student > Doctoral Student"=>1, "Researcher"=>1, "Other"=>2, "Student > Bachelor"=>2, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_subject_area"=>{"Medicine and Dentistry"=>6, "Neuroscience"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>6}, "Neuroscience"=>{"Neuroscience"=>1}}, "group_count"=>0}

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• http://doi.org/10.3390/app9122577
• http://doi.org/10.1080/09273948.2018.1501495
• http://doi.org/10.1080/01658107.2019.1604764
• http://doi.org/10.3892/etm.2016.3681
• http://doi.org/10.3892/etm.2016.3910
• http://doi.org/10.1371/journal.pone.0242920
• http://doi.org/10.1097/OPX.0000000000001170

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Figshare

• {"files"=>["https://ndownloader.figshare.com/files/2527494"], "description"=>"<p>The macular area in the eye with central retinal artery occlusion shows capillary dropout (nonperfusion) at 3 days (FA image obtained 7 min after intravenous fluorescein injection) and demonstrates reversal of no-reflow at 1 month (FA image obtained 4 min and 30 s after fluorescein injection).</p>", "links"=>[], "tags"=>["phenomenon", "CRAO stage", "ci", "macular capillary nonperfusion", "risk factors", "1 week", "outcomes.MethodsIn 102 eyes", "recanalization", "Central Retinal Artery Occlusion", "fluorescein angiography images", "102 CRAO eyes", "incidence", "Clinical Implications PurposeTo"], "article_id"=>1610272, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Seong Joon Ahn", "Kyu Hyung Park", "Na-Kyung Ryoo", "Jeong-Ho Hong", "Cheolkyu Jung", "Chang-Hwan Yoon", "Moon-Ku Han", "Se Joon Woo"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0142852.g005", "stats"=>{"downloads"=>1, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Fluorescein_angiography_FA_images_of_the_eye_with_reversal_of_no_reflow_obtained_3_days_left_and_1_month_right_after_treatment_intra_arterial_thrombolysis_/1610272", "title"=>"Fluorescein angiography (FA) images of the eye with reversal of no-reflow obtained 3 days (left) and 1 month (right) after treatment (intra-arterial thrombolysis).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-11-23 15:21:36"}
• {"files"=>["https://ndownloader.figshare.com/files/2527495"], "description"=>"<p>CRAO = central retinal artery occlusion; IAT = intra-arterial thrombolysis; NLP = no light perception</p><p>Continuous data are presented as mean ± standard deviation.</p><p>Clinical and demographic characteristics of the study patients.</p>", "links"=>[], "tags"=>["phenomenon", "CRAO stage", "ci", "macular capillary nonperfusion", "risk factors", "1 week", "outcomes.MethodsIn 102 eyes", "recanalization", "Central Retinal Artery Occlusion", "fluorescein angiography images", "102 CRAO eyes", "incidence", "Clinical Implications PurposeTo"], "article_id"=>1610273, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Seong Joon Ahn", "Kyu Hyung Park", "Na-Kyung Ryoo", "Jeong-Ho Hong", "Cheolkyu Jung", "Chang-Hwan Yoon", "Moon-Ku Han", "Se Joon Woo"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0142852.t001", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Clinical_and_demographic_characteristics_of_the_study_patients_/1610273", "title"=>"Clinical and demographic characteristics of the study patients.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-11-23 15:21:36"}
• {"files"=>["https://ndownloader.figshare.com/files/2527497"], "description"=>"<p>P values were obtained by Student’s t test for continuous variables and by Fisher’s exact test or Chi-square test for dichotomous or ordinary variables.</p><p>Comparison of clinical and retinal structural characteristics between patients with and without no-reflow phenomenon.</p>", "links"=>[], "tags"=>["phenomenon", "CRAO stage", "ci", "macular capillary nonperfusion", "risk factors", "1 week", "outcomes.MethodsIn 102 eyes", "recanalization", "Central Retinal Artery Occlusion", "fluorescein angiography images", "102 CRAO eyes", "incidence", "Clinical Implications PurposeTo"], "article_id"=>1610274, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Seong Joon Ahn", "Kyu Hyung Park", "Na-Kyung Ryoo", "Jeong-Ho Hong", "Cheolkyu Jung", "Chang-Hwan Yoon", "Moon-Ku Han", "Se Joon Woo"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0142852.t002", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Comparison_of_clinical_and_retinal_structural_characteristics_between_patients_with_and_without_no_reflow_phenomenon_/1610274", "title"=>"Comparison of clinical and retinal structural characteristics between patients with and without no-reflow phenomenon.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-11-23 15:21:36"}
• {"files"=>["https://ndownloader.figshare.com/files/2527477"], "description"=>"<p>FA images (obtained 30 s after intravenous fluorescein injection) show improved arterial perfusion following intra-arterial thrombolysis (IAT) in both eyes, although a round area (yellow arrowheads) exhibiting capillary nonperfusion (and consequently retinal tissue nonperfusion) in the macula is observed only in the no-reflow eye.</p>", "links"=>[], "tags"=>["phenomenon", "CRAO stage", "ci", "macular capillary nonperfusion", "risk factors", "1 week", "outcomes.MethodsIn 102 eyes", "recanalization", "Central Retinal Artery Occlusion", "fluorescein angiography images", "102 CRAO eyes", "incidence", "Clinical Implications PurposeTo"], "article_id"=>1610267, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Seong Joon Ahn", "Kyu Hyung Park", "Na-Kyung Ryoo", "Jeong-Ho Hong", "Cheolkyu Jung", "Chang-Hwan Yoon", "Moon-Ku Han", "Se Joon Woo"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0142852.g001", "stats"=>{"downloads"=>3, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Fundus_photographs_Fd_and_fluorescein_angiography_FA_images_of_no_reflow_left_and_reflow_right_eyes_with_central_retinal_artery_occlusion_/1610267", "title"=>"Fundus photographs (Fd) and fluorescein angiography (FA) images of no-reflow (left) and reflow (right) eyes with central retinal artery occlusion.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-11-23 15:21:36"}
• {"files"=>["https://ndownloader.figshare.com/files/2527480"], "description"=>"<p>The no-reflow phenomenon was defined as the lack of tissue (capillary) reperfusion after successful arterial recanalization in this study. Among the 102 enrolled patients whose arterial recanalization was confirmed by fluorescein angiography (FA) images, 39 showed tissue (capillary) nonperfusion, resulting in a 38.2% incidence of the no-reflow phenomenon. Its reversal could be evaluated in 29 patients, 7 (24.1%) of whom showed reversal of no-reflow.</p>", "links"=>[], "tags"=>["phenomenon", "CRAO stage", "ci", "macular capillary nonperfusion", "risk factors", "1 week", "outcomes.MethodsIn 102 eyes", "recanalization", "Central Retinal Artery Occlusion", "fluorescein angiography images", "102 CRAO eyes", "incidence", "Clinical Implications PurposeTo"], "article_id"=>1610268, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Seong Joon Ahn", "Kyu Hyung Park", "Na-Kyung Ryoo", "Jeong-Ho Hong", "Cheolkyu Jung", "Chang-Hwan Yoon", "Moon-Ku Han", "Se Joon Woo"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0142852.g002", "stats"=>{"downloads"=>2, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Incidence_of_the_no_reflow_phenomenon_and_its_reversal_in_patients_with_central_retinal_artery_occlusion_CRAO_/1610268", "title"=>"Incidence of the no-reflow phenomenon and its reversal in patients with central retinal artery occlusion (CRAO).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-11-23 15:21:36"}
• {"files"=>["https://ndownloader.figshare.com/files/2527483"], "description"=>"<p>(A) Temporal patterns of central macular thickness (CMT) and (B) 1-month and final changes in CMT in eyes with central retinal artery occlusion (CRAO). No-reflow eyes show a greater CMT at baseline but a lesser CMT at the final visit compared with reflow eyes. CMT changes at 1-month and final visits are significantly greater in no-reflow eyes. (C) Temporal patterns of best-corrected visual acuities (BCVAs) and (D) 1-month and final changes in BCVA in patients with reflow and no-reflow for CRAO. No-reflow eyes show worse visual function at baseline, 1 month, and the final visit. At the 1-month and final visits, BCVA changes from baseline are greater in the reflow eyes than in the no-reflow eyes. Error bars denote the upper boundary of 95% confidence intervals. *Statistical significance (P < 0.05).</p>", "links"=>[], "tags"=>["phenomenon", "CRAO stage", "ci", "macular capillary nonperfusion", "risk factors", "1 week", "outcomes.MethodsIn 102 eyes", "recanalization", "Central Retinal Artery Occlusion", "fluorescein angiography images", "102 CRAO eyes", "incidence", "Clinical Implications PurposeTo"], "article_id"=>1610269, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Seong Joon Ahn", "Kyu Hyung Park", "Na-Kyung Ryoo", "Jeong-Ho Hong", "Cheolkyu Jung", "Chang-Hwan Yoon", "Moon-Ku Han", "Se Joon Woo"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0142852.g003", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Anatomical_and_visual_outcomes_of_eyes_with_and_without_the_no_reflow_phenomenon_/1610269", "title"=>"Anatomical and visual outcomes of eyes with and without the no-reflow phenomenon.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-11-23 15:21:36"}
• {"files"=>["https://ndownloader.figshare.com/files/2527488"], "description"=>"<p>An optical coherence tomography (OCT) image of the no-reflow eye shows loss of layer-by-layer structure in the inner retina and remarkable macular thickening. In contrast, the reflow eye shows a relatively preserved layered retinal structure at baseline (top) and 1 (middle) and 6 months (bottom) later. Furthermore, the no-reflow eye shows more remarkable retinal thinning than the reflow eye and loss of an organized layered retinal structure in the macula.</p>", "links"=>[], "tags"=>["phenomenon", "CRAO stage", "ci", "macular capillary nonperfusion", "risk factors", "1 week", "outcomes.MethodsIn 102 eyes", "recanalization", "Central Retinal Artery Occlusion", "fluorescein angiography images", "102 CRAO eyes", "incidence", "Clinical Implications PurposeTo"], "article_id"=>1610270, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Seong Joon Ahn", "Kyu Hyung Park", "Na-Kyung Ryoo", "Jeong-Ho Hong", "Cheolkyu Jung", "Chang-Hwan Yoon", "Moon-Ku Han", "Se Joon Woo"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0142852.g004", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Structural_changes_in_the_retina_over_time_in_the_reflow_left_and_no_reflow_right_eyes_for_central_retinal_artery_occlusion_CRAO_/1610270", "title"=>"Structural changes in the retina over time in the reflow (left) and no-reflow (right) eyes for central retinal artery occlusion (CRAO).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-11-23 15:21:36"}

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