Arteriovenous sheathotomy for persistent macular edema in branch retinal vein occlusion.

Published on Dec 1, 2006in Korean Journal of Ophthalmology
· DOI :10.3341/KJO.2006.20.4.210
Joon Hong Sohn1
Estimated H-index: 1
,
Su Jeong Song6
Estimated H-index: 6
(SKKU: Sungkyunkwan University)
+ -1 AuthorsSu Jeong Song6
Estimated H-index: 6
(SKKU: Sungkyunkwan University)
Sources
Abstract
Branch retinal vein occlusion is the second most common cause of retinal vascular disease after diabetic retinopathy.1,2 Many patients with BRVO experience a decrease in visual acuity because of macular edema, retinal ischemia or hemorrhage.2 The Branch Retinal Vein Occlusion Study demonstrated that eyes treated with argon laser photocoagulation for macular edema gained a mean improvement of visual acuity of 1.3 lines whereas the control group gained 0.2 lines.2 Recently, improvement in macular edema and visual acuity after intravitreal triamcinolone injections on macular edema in BRVO have been reported.3 However, these therapeutic results were not satisfactory in many cases because recurrent or persistent macular edema is common even after laser photocoagulation or intravitreal triamcinolone injections.4 After the first report by Osterloh and Chales in 1988, several investigators reported significant improvement of macular edema and visual acuity after arteriovenous sheathotomy for decompression of macular edema in BRVO.5-9 This surgical approach is based on the fact that BRVO takes place at the site of arteriovenous crossing where the artery and the vein shared a common vascular adventitia. Although the exact mechanism responsible for the improvement of visual acuity after vitrectomy and arteriovenous sheathotomy is still not clear, Mason et al reported that surgery halved the visual angle in 75% of patients compared with 40% of the control group.10 Charbonnel et al also reported visual acuity improvement of two ETDRS lines or more in 69% of patients with a mean gain of 1.9 ETDRS lines.11 However, most of these results are in eyes with relatively short BRVO duration and excluded the eyes with recurrent or persistent macular edema in BRVO after laser or intravitreal triamcinolone injections. The purpose of this study is to investigate the anatomic and functional results after arteriovenous sheathotomy with ILM peeling for persistent or recurrent macular edema in BRVO.
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