Internal limiting membrane peeling for decompression of macular edema in retinal vein occlusion: a report of 14 cases.
BACKGROUND
Currently, there is no proven treatment for macular edema due to central retinal vein occlusion (CRVO). Moreover, not all cases with macular edema due to branch retinal vein occlusion (BRVO) respond to laser photocoagulation. We postulated that internal limiting membrane (ILM) peeling for decompression of macular edema in cases of retinal vein occlusion would facilitate egress of blood and extracellular fluid out of the inner retinal layers, leading to reduction of macular edema and improvement in visual acuity.


METHODS
Fourteen consecutive patients with macular edema due to CRVO or selected cases of BRVO, not eligible for laser photocoagulation, underwent pars plana vitrectomy with removal of preretinal hyaloid and peeling of the ILM stained with indocyanine green dye.


RESULTS
In all cases, intraretinal blood and retinal thickening diminished within 6 weeks of surgery. Visual acuity improved in 78.6% of cases. No surgical complications occurred, although one patient developed nuclear cataract 10 months postoperatively.


CONCLUSIONS
Pars plana vitrectomy with ILM peeling in selected cases of CRVO and BRVO showed improvement in visual acuity in this nonrandomized, noncontrolled study. This pilot study adds support to the concept that ILM peeling may of visual benefit when compared with the natural history in these vaso-occlusive diseases.
Mandelcorn
Mark S
MS
Department of Ophthalmology and Vision Science, University of Toronto, Toronto, Ontario, Canada. mark.mandelcorn@utoronto.ca
Nrusimhadevara
Ravi Krishna
RK
D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000601:surgery*; D004396:Coloring Agents; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008269:Macular Edema / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012170:Retinal Vein Occlusion / Q000150:complications / Q000601:surgery*; D014792:Visual Acuity; D014821:Vitrectomy
D004396:Coloring Agents; D007208:Indocyanine Green