Vitrectomy with arteriovenous decompression and dissection of the internallimiting membrane in branch retinal vein occlusion

Background. Our therapeutical armamentarium for functional improvement afte r branch retinal vein occlusion (BRVO) is still limited and the efficacy is uncertain. Recently, surgical decompression of the vein at the arterioveno us crossing (AV decompression) has again been proposed as a suitable form o f treatment. Material and methods. A total of 40 patients with BRVO were treated in our department from August 1999 to February 2001 with AV decompression and 22 p atients with comparable BRVO who refused this surgical intervention served as control. The surgical procedure consisted of a standard pars plana vitre ctomy and separation of the overlying artery from the vein using microsciss ors. In 13 cases dissection of the internal limiting membrane was additiona lly performed. Assessment of visual acuity, fluorescein angiography and mul tifocal ERG in 7 patients was performed preoperatively and 6 weeks after su rgery. Results. The surgical procedure and postoperative course were uneventful. I n most of the treated eyes, visual acuity improved and fluorescein angiogra phy revealed capillary reperfusion. Functional results in patients with AV- decompression were highly significantly better than in the control group. Conclusion. Our results with surgical decompression of branch retinal vein occlusions demonstrate the therapeutical effect of surgical AV-decompressio n in BRVO. Further experience is necessary before some open questions can b e answered.