[Arteriovenous decompression for branch retinal vein occlusion with internal membrane peeling for macular edema].
OBJECTIVE
A retrospective study of anatomical and functional results of microsurgical therapy of branch retinal vein occlusion with internal limiting membrane peeling due to macular edema.


METHODS
Eleven patients (5 men and 6 women), mean age 59.18 years (34-74 years) who underwent the surgery at the Department of Ophthalmology, Comenius University in Bratislava, Slovak Republic, from June 1st, 2000 to May 31st, 2006, were enrolled in the study. The follow-up period ranged from 14 to 72 months (average 28.5 months). The patients were indicated to the arterio-venous decompression with internal retinal membrane peeling due to the macular edema after the fluorescein angiography. Patients with rubeosis of the iris were excluded from further evaluation and their initial best corrected visual acuity was 0.3 and less. A complete eye examination (best corrected visual acuity, intraocular pressure, fluorescein angiography, slit lamp examination of both the anterior and posterior eye segments) was performed in each patient before the surgery, and every 3-4 months during the first year and every 6-9 months during following years. Fluorescein angiography was used to evaluate anatomic results 3 months after the surgery. As positive signs were considered: the blood flow improvement peripherally to the arteriovenous decompression site, the vessel dilatation, and the reduction of the hyperfluorescence and the macular edema reduction. To analyze the functional results, the best corrected visual acuity changes before and after surgery were used.


RESULTS
Positive anatomic changes were in 8 (72,73%) patients; in 1 patient the area of non-perfusion expanded, and 2 patients were presented with stable anatomic findings. The best corrected visual acuity averaged 0.16 (+/- 0.1070) before the surgery, 0.2909 (+/- 0.2264) 3 months after the surgery, and 0.3818 (+/- 0.3178) at the time of the last examination. Significant differences between the visual acuity before and 3 months after surgery were confirmed by Student's T-test. The visual acuity measured at the time of the last measurement improved by +2 and more lines in 6 patients, reminded unchanged in 4 patients, and worsened by -2 or more lines in 1 patient.


CONCLUSIONS
Microsurgical treatment of branch retinal vein occlusion expands the therapeutic armamentarium used to manage this severe disease. In case the partial occlusion is present, arteriovenous decompression has a positive effect on the final anatomic and functional results.
Krásnik
V
V
Klinika oftalmológie LF UK, Bratislava. krasnik@ruzinov.fnspba.sk
Strmen
P
P
Stefanicková
J
J
Krajcová
P
P
D000328:Adult; D000368:Aged; D019299:Decompression, Surgical; D019773:Epiretinal Membrane / Q000601:surgery*; D005260:Female; D006801:Humans; D008269:Macular Edema / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D012170:Retinal Vein Occlusion / Q000150:complications / Q000601:surgery*