[Treatment of retinal vein occlusion. Vitrectomy with arteriovenous decompression and dissection of the internal limiting membrane].
BACKGROUND
Our therapeutical armamentarium for functional improvement after branch retinal vein occlusion (BRVO) is still limited and the efficacy is uncertain. Recently, surgical decompression of the vein at the arteriovenous crossing (AV decompression) has again been proposed as a suitable form of treatment.


METHODS
A total of 40 patients with BRVO were treated in our department from August 1999 to February 2001 with AV decompression and 22 patients with comparable BRVO who refused this surgical intervention served as control. The surgical procedure consisted of a standard pars plana vitrectomy and separation of the overlying artery from the vein using microscissors. In 13 cases dissection of the internal limiting membrane was additionally performed. Assessment of visual acuity, fluorescein angiography and multifocal ERG in 7 patients was performed preoperatively and 6 weeks after surgery.


RESULTS
The surgical procedure and postoperative course were uneventful. In most of the treated eyes, visual acuity improved and fluorescein angiography revealed capillary reperfusion. Functional results in patients with AV-decompression were highly significantly better than in the control group.


CONCLUSIONS
Our results with surgical decompression of branch retinal vein occlusions demonstrate the therapeutical effect of surgical AV-decompression in BRVO. Further experience is necessary before some open questions can be answered.
Mester
U
U
Augenklinik der Bundesknappschaft, An der Klinik 10, 66280 Sulzbach. mester@kksulzbach.de
Dillinger
P
P
D000368:Aged; D019299:Decompression, Surgical; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012170:Retinal Vein Occlusion / Q000601:surgery*; D013997:Time Factors; D014792:Visual Acuity; D014821:Vitrectomy