Comparative study of vitrectomy with and without vein decompression for branch retinal vein occlusion. A pilot study
Purpose: To prospectively compare results of vein decompression and vitrectomy with hyaloid removal for treating branch retinal vein occlusion (BRVO).
Methods: Thirty-five eyes with macular edema and visual acuity worse than 20/100 secondary to BRVO were included. Vitrectomy with posterior hyaloid removal and vein decompression at the arteriovenous crossing was performed on 15 patients (Group I); same technique without vein decompression was performed on 20 (Group II).
Results: Group I: After mean follow-up of 33 months, VA improved by two lines or more in 13/15 (87%), one line in 1/15 (6.5%) and remained unchanged in 1/15 (6.5%) eyes. Macular edema resolved in 14/15 (93%). No eyes developed new vessels.
Group II. After mean follow-up of 18 months, VA improved two lines or more in 16/20 (80%), remained unchanged in 2/20 (10%) and deteriorated in 2/20 (10%). Macular edema resolved in 16/20 (80%). No new vessels developed. No differences were found between groups in either age (p 0.566) or preoperative visual acuity (p 0.505). Despite a statistically significant difference in the duration of preoperative interval (p 0.004), no differences were found in post-operative visual results (p 0.147), resolution of macular edema (p 0.098) or prevention of neovascularization.
Conclusion: Results suggest that vitrectomy with posterior hyaloid removal without vein decompression can resolve macular edema, improve visual acuity and prevent development of new vessels in BRVO.
KeywordsVisual Acuity Macular Edema Diabetic Macular Edema Retinal Vein Occlusion Central Retinal Vein Occlusion
Unable to display preview. Download preview PDF.
- 1.Mitchell P, Smith W, Chang A (1996) Prevalence and association of retinal vein occlusion in Australia. The Blue Mountains Eye Study. Arch Ophthalmol 114: 1243–7Google Scholar
- 2.Fryczkowski AW, Sato SE (1987) Scanning electron microscopy evaluation of arteriovenous crossing phenomenon. Contemp Ophthalmic Forum 5: 184–92Google Scholar
- 6.Staurenghi G, Lonati Ch, Aschero M, Orzalesi N (1994) Arteriovenous crossing as a risk factor in branch retinal vein occlusion. Am J Ophthalmol 117: 211–13Google Scholar
- 9.Argon laser scatter photocoagulation for prevention of neovascularization and vitreous hemorrhage in branch vein occlusion. A randomised clinical trial. The Branch Vein Occlusion Study Group (1986) 104: 34–41Google Scholar
- 13.Mester U, Dillinger P (2001) Treatment of retinal vein occlusion. Vitrectomy with arteriovenous decompression and dissection of the internal limiting membrane. Opthalmologe 98: 1104–9Google Scholar
- 14.Dotrelova D, Dubska Z, Kuthan P, Stepankova J (2001) Initial experience with surgical decompression of the vein in branch retinal vein occlusion. Cesk Slov Oftalmol 57: 359–66Google Scholar
- 15.Le Rouic JF, Bejjani RA, Rumen F, et al (2001) Adventitial sheathotomy for decompression of recent onset branch retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 239: 747–51Google Scholar
- 16.Tachi N, Hashimoto Y, Ogino N (1999) Vitrectomy for macular edema combined with retinal occlusion. Documenta Ophthalmologica 97: 465–9Google Scholar
- 17.Saika S, Tanaka T, Miyamoto T, Ohnishi Y (2001) Surgical posterior vitreous detachment combined with gas/air tamponade for treating macular edema associated with retinal vein occlusion: retinal tomography and visual outcome. Graefes Arch Clin Exp Ophthalmol 239: 729–32Google Scholar
- 20.Eccarius SG, Moran MJ, Slingsby JG (1996) Choroidal neovascular membrane after laser-induced chorioretinal anastomosis. Am J Ophthalmol 122: 590–1Google Scholar
- 21.Yarng S-S, Hsieh C-L (1996) Chorioretinal neovascularization following laser-induced chorioretinal venous anastomosis. Ophthalmology 103: 136Google Scholar
- 22.Browning DJ, Rotberg MH (1996) Vitreous hemorrhage complicating laser-induced chorioretinal anastomosis for central retinal vein occlusion. Am J Ophthalmol 122: 588–9Google Scholar
- 23.Luttrull JK (1997) Epiretinal membrane and traction retinal detachment complicating laser-induced chorioretinal venous anastomosis. Am J Ophthalmol 123: 698–9Google Scholar
- 24.Minamikawa M, Yamamoto K, Okuma H (1993) Experimental retinal branch vein occlusion. 4. Pathological changes in the middle and late stage. Nippon Ganka Gakkai Zasshi 97: 920–7Google Scholar
- 25.Stefânsson E, Novack RL, Hatchell DL (1990) Vitrectomy prevents retinal hypoxia in branch retinal vein occlusion. Invest Ophthalmol Vis Sci 31: 284–9Google Scholar
- 26.Arnarsson A, Stefânsson E (2000) Laser treatment and the mechanism of edema reduction in branch retinal vein occlusion. Invest Ophthalmol Vis Sci 41: 877–9Google Scholar
- 27.Peer J, Folberg R, Itin A, et al (1998) Vascular endothelial growth factor up regulation in human central retinal vein occlusion. Ophthalmology 105: 412–16.Google Scholar
- 29.Funatsu H, Yamashita H, Ikeda T, et al (2002) Angiotensin II and vascular endothelial growth factor in the vitreous fluid of patients with diabetic macular edema and other retinal disorders. Am J Ophthalmol 133: 537–43Google Scholar