Long-term visual outcomes after vitrectomy for macular edema with foveal hemorrhage in branch retinal vein occlusion.
OBJECTIVE
To determine the long-term visual outcomes after vitreous surgery for macular edema with foveal hemorrhage associated with branch retinal vein occlusion (BRVO).


METHODS
One hundred twenty eyes of 120 patients underwent pars plana vitrectomy with or without internal limiting membrane (ILM) peeling for macular edema with foveal hemorrhage due to BRVO with a minimum 12 months of follow-up. Simultaneous cataract extraction with intraocular lens implantation was performed on 117 phakic eyes.


RESULTS
Follow-up after surgery ranged from 12 months to 129 months (average, 48 months). Visual acuity improved in 71% of cases at the 1-year visit. Mean visual acuity significantly increased from 0.24 (median, 0.3) before surgery to 0.57 (median, 0.7) 1 year after surgery (P < 0.0001) and 0.66 (median, 0.9) at the final visit (P < 0.0001). There was a significant difference between visual acuity at 1 year after surgery and visual acuity at the final visit (P < 0.0001). Of 120 patients, 95 (79%) had final visual acuity of > or =0.5, and 55 (46%) had final visual acuity of > or =1.0. ILM removal did not seem to have significant beneficial effects on visual outcomes in this series. No serious complications occurred during the follow-up period.


CONCLUSIONS
After vitreous surgery for macular edema with foveal hemorrhage associated with BRVO, visual acuity continued to improve beyond 1 year after surgery. A randomized, multicenter clinical trial is warranted to determine the efficacy of this procedure.
Kumagai
Kazuyuki
K
Shinjo Ophthalmologic Institute, 889 Mego, Shimoki-takata-cho, Miyazaki 880-0035, Japan. kumagai3@f8.dion.ne.jp
Furukawa
Mariko
M
Ogino
Nobuchika
N
Larson
Eric
E
Uemura
Akinori
A
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D005260:Female; D005500:Follow-Up Studies; D005584:Fovea Centralis; D006801:Humans; D019654:Lens Implantation, Intraocular; D008269:Macular Edema / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012166:Retinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D012170:Retinal Vein Occlusion / Q000150:complications*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy