Vitrectomy with or without arteriovenous adventitial sheathotomy for macular edema associated with branch retinal vein occlusion

• Published in: American journal of ophthalmology Vol. 138; no. 6; pp. 907 - 914
• Main Authors: Yamamoto, Shuichi, Saito, Wataru, Yagi, Fumihiko, Takeuchi, Shinobu, Sato, Eiju, Mizunoya, Satoshi
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.12.2004; Elsevier; Elsevier Limited
• Subjects: Aged; Aging; Biological and medical sciences; Blood clots; Cataracts; Connective Tissue - pathology; Connective Tissue - surgery; Decompression, Surgical; Diabetic retinopathy; Female; Fluorescein Angiography; Hospitals; Humans; Macular Edema - diagnosis; Macular Edema - etiology; Macular Edema - surgery; Male; Medical sciences; Middle Aged; Ophthalmology; Retinal Artery; Retinal Vein; Retinal Vein Occlusion - complications; Retinal Vein Occlusion - diagnosis; Retinal Vein Occlusion - surgery; Retinopathies; Retrospective Studies; Surgery; Tomography, Optical Coherence; Treatment Outcome; Veins & arteries; Visual Acuity; Vitrectomy; Retinopathy; Cardiovascular disease; Retinal edema; Venous disease; Vascular disease; Macula; Central retinal vein occlusion; Eye disease; Association; Treatment; Branch; Surgery; Vitrectomy; Ophthalmology
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2004.06.061

compare the results of vitrectomy with or without arteriovenous (AV) crossing sheathotomy for macular edema associated with branch retinal vein occlusion (BRVO). Interventional case series. A retrospective study of 36 eyes with BRVO-associated macular edema. Twenty eyes underwent AV sheathotomy (AS group), and 16 eyes underwent posterior vitreous detachment (PVD group). Best-corrected visual acuity (BCVA), fluorescein angiography (FA), and optical coherence tomography to determine foveal thickness were conducted preoperatively and at 12 months postoperatively. The mean postoperative BCVAs were significantly better in both the AS and the PVD group (P = .008 and P = .001, respectively). Foveal thickness decreased significantly 1 month after surgery in both groups (P = .002 and P = .007) and continued to decrease up to 12 months. The postoperative mean BCVA and improvement of BCVA and foveal thickness were not significantly different for the two groups at any postoperative period. Postoperative FA showed reperfusion of the occluded vein in 10 eyes in the AS group and 2 eyes in the PVD group, and formation of shunt vessels at the AV crossing site or around the macular region in all of the other eyes of both groups. Both AV sheathotomy and simple PVD significantly reduced macular edema associated with BRVO. However, there was no significant difference in the improvement of macular function following either procedure. Postoperative improvement of retinal circulation by either reperfusion of the occluded vein or collateral vessel formation was found. This accounted for functional and morphologic improvements.