Em. Opremcak et Ra. Bruce, Surgical decompression of branch retinal vein occlusion via arteriovenous crossing sheathotomy - A prospective review of 15 cases, RETINA, 19(1), 1999, pp. 1-5
Citations number
11
Categorie Soggetti
Optalmology
Journal title
RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES
Background: Branch retinal vein occlusion (BRVO), the second most common va
scular disorder of the retina, typically occurs at arteriovenous (A/V) cros
sings where the arteriole and venule share a common adventitial sheath. Mec
hanical narrowing of the Venous lumen at these intersections is thought to
play a pathoetiologic role in BRVO.
Methods: We performed surgical decompression of BRVO via A/V crossing sheat
hotomy in 15 patients with decreased visual acuity due to macular hemorrhag
e, edema, and ischemia. Reperfusion of the retina was achieved by surgicall
y separating the overlying retinal arteriole from the venule via vitrectomy
and adventitial sheathotomy techniques.
Results: Intraoperative decompression of the A/V crossing was achieved in a
ll 15 patients. All patients showed clinical improvement as determined by f
undus examination, photography, and fluorescein angiography. Postoperative
visual acuities were equal or improved in 80% of patients. Ten of the 15 su
bjects (67%) had improved visual acuity with an average gain of four lines
of vision.
Conclusion: Surgical decompression of BRVO via A/V crossing sheathotomy is
a technically feasible procedure that can result in rapid reperfusion of th
e retina. Resolution of macular hemorrhage, edema, and ischemia may improve
visual prognosis in patients with this common retinal vascular disorder.