title: Retinal detachment after branch retinal vein occlusion: influence of the type of break on the outcome of vitreous surgery.
abstract: BACKGROUND
  Branch retinal vein occlusion (BRVO) is occasionally complicated by two types of retinal breaks (retinal holes without vitreous traction or retinal traction tears) that may lead to a rhegmatogenous retinal detachment (RRD). The authors describe surgical results of vitrectomy for RRD after BRVO and investigate whether there is any difference between clinical features or surgical results from eyes with the two types of retinal breaks.
  
  
  METHODS
  The authors retrospectively studied 25 patients (25 eyes) who underwent vitrectomy for RRD after BRVO. Twelve of 25 eyes (48%) had a detachment secondary to one or more retinal holes (group I), and 13 of the eyes (52%) had one or more retinal tears (group II).
  
  
  RESULTS
  Seventeen of the eyes (68%) achieved total retinal reattachment after the initial surgery; 22 (88%) did so by the time of final examination. Patients with retinal holes achieved more favorable final vision than those with retinal tears (P = 0.0391). A higher rate of preoperative macular detachment (P = 0.0112) and a higher rate of recurrent retinal detachment after initial vitrectomy (P = 0.0302) were the factors associated with the reduced final visual acuity in patients with retinal tears. The increased rate of recurrent retinal detachment in patients with retinal tears was associated with a higher rate of existing preretinal neovascular membranes (P = 0.0112) and a trend toward an increased incidence of intraoperative iatrogenic retinal breaks.
  
  
  CONCLUSIONS
  Among patients who undergo vitrectomy for RRD after BRVO, better surgical results are expected in eyes with retinal holes without vitreous traction than in those with retinal traction tears. This difference is thought to be due to the difference in vitreoretinal anatomy between eyes with the two types of retinal breaks.
authors.affiliation: Division of Ophthalmology, Osaka National Hospital, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ikuno
authors.forename: Y
authors.initials: Y
authors.lastname: Tano
authors.forename: J M
authors.initials: JM
authors.lastname: Lewis
authors.forename: T
authors.initials: T
authors.lastname: Ikeda
authors.forename: Y
authors.initials: Y
authors.lastname: Sato
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012163:Retinal Detachment / Q000209:etiology* / Q000601:surgery; D012167:Retinal Perforations / Q000150:complications / Q000473:pathology* / Q000601:surgery; D012170:Retinal Vein Occlusion / Q000150:complications*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy