ABSTRACT
PURPOSE: To evaluate long-term visual outcome of arteriovenous adventitial sheathotomy in BRVO-induced macular edema. METHODS: The visual outcomes of 8 patients following vitrectomy with arteriovenous adventitial sheathotomy for BVO-induced macular edema (surgery group) were retrospectively evaluated. The three-year post-operative visual acuity of the surgery group was compared with that of the conservatively managed controls. RESULTS: All patients were followed for a minimum of 36 months. Mean BCVA (logMAR) in the surgery group changed from 1.10+/-0.34 to 1.19+/-0.70 and to 0.80+/-0.36 at 12 and 36 months, respectively (p=0.959 at 12 months, p=0.018 at 36 months). In the control group, visual acuity improved from 1.15+/-0.43 to 0.43+/-0.44 and to 0.43+/-0.39 at 12 and 36 months, respectively (p=0.015 at 12 months, at p=0.003 at 36 months). A strong trend toward better visual acuity at 12 months and final examination was observed for controls. (surgery vs. control group, p=0.052 at 12 months, p=0.066 at 36 months). CONCLUSIONS: Considering the favorable natural course of BVO and the unproven effect of reperfusion on macular edema, surgical efficacy of arteriovenous adventitial sheathotomy requires further evaluation.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Connective Tissue/surgery , Decompression, Surgical/methods , Macular Edema/etiology , Retinal Artery , Retinal Vein , Retinal Vein Occlusion/complications , Retrospective Studies , Treatment Outcome , Visual Acuity/physiology , Vitrectomy/methodsABSTRACT
PURPOSE: We evaluated the effect of vitrectomy and arteriovenous adventitial sheathotomy for branch retinal vein occlusion (BRVO) according to operation timing and obstruction site. METHODS: We performed vitrectomy and arteriovenous adventitial sheathotomy in 14 eyes with BRVO. Patient selection criteria were foveal involvement of macular hemorrhage or macular edema and a best corrected visual acuity (BCVA) of 0.1 or less. We compared 7 eyes with symptom duration of 2 months or less (Group 1) and 7 eyes with symptom duration of more than 2 months (Group 2). We analyzed 7 eyes for which the obstruction site was 1 disc diameter (DD) or less from the disc margin (Group A) and 7 eyes of more than 1 DD (Group B). RESULTS: Seven of 14 eyes (50%) had visual improvement. Six eyes of Group 1 (86%) had visual improvement and Group 1 had better visual improvement than Group 2. There was a statistically significant difference between Groups 1 and 2 (p=0.029). Five eyes of Group A (71%) had visual improvement and Group A had better visual improvement than Group B. There was no statistically significant difference (p=0.286). CONCLUSIONS: In the case of foveal involvement of macular hemorrhage or macular edema and a BCVA of 0.1 or less, vitrectomy and arteriovenous adventitial sheathotomy are effective in early BRVO.