title: Adventitial sheathotomy for decompression of recent onset branch retinal vein occlusion.
abstract: Interesting results have been reported on the use of pars plana vitrectomy with adventitial sheathotomy for the decompression of branch retinal vein occlusions (BRVO). Recent onset BRVO responsible for a visual acuity of 20/40 or less have been estimated to be good candidates for this procedure. We report on the results of the prospective evaluation of three eyes (in three patients) with recent onset BRVO which underwent surgical decompression. Three men, aged 40, 50, and 68 years presenting with BRVO for 4, 4, and 3 weeks respectively, underwent surgical decompression. Initial visual acuity was 20/80, 20/80, and 20/200. After 11, 10, and 9 months follow-up, visual acuity was 20/80, 20/200, and 20/200. In two eyes, an increase of the area of retinal non-perfusion was treated with peripheral laser photocoagulation. No cataract, retinal tears or retinal detachment were observed.
  
  
  CONCLUSIONS
  although feasible, sheathotomy did not lead to a significant visual improvement in our patients. Dissection of the arteriovenous crossing could have induced vascular trauma. Furthermore, vitrectomy with posterior hyaloid detachment alone could be of benefit in the treatment of branched retinal vein occlusions. A prospective randomised trial is needed to assess the effectiveness and the safety of this procedure and to determine the best candidates for surgery.
authors.affiliation: Service d'Ophthalmologie, Hôtel-Dieu de Paris, France. jflr@caramail.com
authors.forename: J F
authors.initials: JF
authors.lastname: Le Rouic
authors.forename: R A
authors.initials: RA
authors.lastname: Bejjani
authors.forename: F
authors.initials: F
authors.lastname: Rumen
authors.forename: C
authors.initials: C
authors.lastname: Caudron
authors.forename: O
authors.initials: O
authors.lastname: Bettembourg
authors.forename: G
authors.initials: G
authors.lastname: Renard
authors.forename: D
authors.initials: D
authors.lastname: Chauvaud
mesh_terms: D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D012170:Retinal Vein Occlusion / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity