title: Trans-luminal nd:YAG laser embolysis for branch retinal artery occlusion.
abstract: OBJECTIVE
  To evaluate the clinical efficacy of transluminal YAG laser embolysis (TYE) for patients with severe vision loss secondary to a newly diagnosed branch retinal artery occlusion (BRAO) with visible emboli.
  
  
  METHODS
  Five eyes of five patients with acute, severe vision loss secondary to a branch retinal artery occlusion with visible emboli and retinal whitening were prospectively examined, enrolled, and underwent visual acuity testing, ophthalmic examination, color photography, and fluorescein angiography. Each patient was offered TYE and the potential risks of the treatment were explained. Follow-up examinations were undertaken post-procedure day 1 and subsequent follow-up depended on the clinical course.
  
  
  RESULTS
  In our five patients baseline best-corrected visual acuity (BCVA) was found to be 5/400, count fingers at 3 feet, count fingers at 5 feet, 20/800, and 20/200. All five of our patients showed improvement in BCVA 1 day after TYE. Fluorescein angiography showed immediate and dramatic restoration in flow past the obstructed arteriole in all patients. Patient 2 developed subretinal hemorrhage, which after vitrectomy and associated procedures the acuity improved to 20/25 at 22 days after the TYE. Final BCVA was 20/30, 20/25, 20/40, 20/30, and 20/40.
  
  
  CONCLUSIONS
  TYE is a treatment modality to be considered in patients with BRAO who present acutely with severe vision loss and a visible embolus. The risks of TYE must be weighed against the possibility of severe and permanent loss of vision secondary to BRAO.
authors.affiliation: Department of Ophthalmology, University of Alabama at Birmingham, Callahan Eye Foundation Hospital, 700 South 18th Street, Birmingham, AL 35233, USA.
authors.forename: John O
authors.initials: JO
authors.lastname: Mason
authors.forename: Peter A
authors.initials: PA
authors.lastname: Nixon
authors.forename: Michael A
authors.initials: MA
authors.lastname: Albert
mesh_terms: D000208:Acute Disease; D000368:Aged; D004621:Embolization, Therapeutic / Q000379:methods*; D005451:Fluorescein Angiography; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012170:Retinal Vein Occlusion / Q000150:complications / Q000628:therapy*; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity