Early Experience with the Surgical Decompression of the Vein in the Branch
Retinal Occlusion
Dotřelová D., Dubská Z., Kuthan P., Štěpánková J.
Oční klinika VFN 1. LF UK, Praha, přednosta doc. MUDr. M. Filipec, CSc. |
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Summary:
Due to the development of the armamentarium and surgical techniques, the
indications of pars plana vitrectomy (PPV) are expanding. It concerns also a relatively new indication, as is the branch retinal vein occlusion (BRVO) of the
temporal part of the posterior pole of the retina with the secondary involvement
of the macular region.
The purpose of this prospective study is to demonstrate anatomical andfunctional
results after the surgical decompression of the occlusion of the branch retinal
vein draining the macular region. Since November 1999, 3 patients, one woman
and 2 men (age 70, 47 and 76 years) with the quadrant BRVO of the temporal part
of the retina involving the macular region were followed. The visual acuity before
the surgery in all 3 patients was 6/36 (20/120 or 0.16) and the BRVO lasted for 3-5
months. The patients were examined by slitlamp biomicroscopy, and the course
of the disease was documented by means of red-free fundus photographs as well
as fluorescein angiograms. In all three patients, PPV and the adventitial sheathotomy of the arteriovenous crossing (AVC) were performed. Surgical decompression of BRVO and reperfusion of the ischemic part of the retina was achieved by
separating the overlying arteriole from the venule at AVC. Neither per- nor postoperative complications were noted. In two patients, the visual acuity impro-
ved to 6/12 (20/40 or 0.5), and in the last one stabilized at 1/9 (20/180 or 0.11). The
minimal follow-up period was 12 months. In conclusion, we recommend to performing this new type of delicate surgery procedure in individual cases on the basis
of detailed biomicroscopial examination and fluorecein angiograms by an experienced vitreoretinal surgeon.
Key words:
surgical decompression of the retinal vein, adventitial sheathotomy
of the arteriovenous crossing, branch retinal vein occlusion (BRVO), pars plana
vitrectomy (PPV)
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