TRACTIONAL RETINAL-DETACHMENT AFTER BRANCH RETINAL VEIN OCCLUSION - INFLUENCE OF DISC NEOVASCULARIZATION ON THE OUTCOME OF VITREOUS SURGERY

Objective: This study aimed to investigate the influence of disc neova scularization on the outcome of vitreous surgery for tractional retina l detachment (TRD) after branch retinal vein occlusion (BRVO). Design: The study design was a retrospective case series. Participants: Twent y-two eyes of 22 patients who had undergone vitrectomy for TRD after B RVO at the Osaka National Hospital (Osaka, Japan) or the Surugadai Hos pital of Nihon University (Tokyo, Japan) between 1985 and 1995 partici pated, Seven (32%) of 22 eyes had a TRD secondary to neovascularizatio n of the optic disc (NVD) and neovascularization elsewhere (NVE; group I), and 15 (68%) had a TRD with NVE without NVD (group II). Main Outc ome Measures: Visual acuities and retinal reattachment rates were meas ured. Results: Sixteen (73%) of the 22 study eyes showed severe vitreo us hemorrhage before surgery, and 11 eyes (50%) had received laser pho tocoagulation treatment before surgery. Fourteen (64%) of the study ey es achieved total retinal reattachment after initial vitrectomy, and 1 9 eyes (86%) were reattached completely at final examination, Thirteen eyes (59%) achieved a visual acuity of better than 0.1, Group I patie nts had a significantly higher rate of recurrent combined traction rhe gmatogenous retinal detachment (P = 0.01) and a significantly worse fi nal visual outcome (P = 0.01). Conclusions: Better surgical results ar e expected in eyes without NVD than with NVD among patients who underg o vitrectomy for TRD after BRVO, Although the authors were unable to d etermine the reason for this difference in the current study, they spe culate that the degree of retinal nonperfusion, diffusible angiogenic factors, and distance of the site of occlusion from the disc may each affect visual and anatomic outcomes in these eyes.