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Ning Lu, Ji P. Li, Ning L. Wang, Lin Li; Induced Lamellar Macular Hole As A New Treatment For Persistent Cystoid Macular Edema From Branch Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2621.
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Branch retinal vein occlusion (BRVO) may cause irreversible visual loss in some patients with persistent cystoid macular edema (CME). We have observed visual improvement after spontaneouslamellar macular hole (LMH) formation in such a patient. In this study we try to assess the efficacy of induced LMH as a new treatment for patients with persistent CME from BRVO.
Four consecutive patients with persistent CME from BRVO received a conventional 20-gauge 3-port vitrectomy with internal limiting membrane (ILM) removal. LMH was induced by cutting open the inner wall of the cyst with a microvitreoretinal blade. Examinations were performed 1 day before surgery and 1 and 3 days as well as 1, 3, 6 months, and yearly intervals after surgery. Visual acuity(VA), ophthalmoscope, and optical coherence tomography (OCT) findings were the main outcome measures.
The age of the patients ranged from 43 to 65 years (median, 56 years) and 3 were female. Duration of the disease ranged from 8-13 months (median, 10 months). Initial visual acuity ranged from 20/100 to 20/80. OCT showed a marked reduction of intraretinal cystic spaces in all eyes within one week after operation. VA improved by 6 or more lines in 2 cases, 2 lines in 1 case and was unchanged in 1 case. In one case, VA improved from 20/80 to 20/30 at one month, and 20/20 at 2 years and remained stable at 3 years postoperatively. OCT showed small cystic spaces around the LMH at 6 months after operation. Complete resolution of cystic spaces was observed 2 years after operation. The follow-up time for the rest cases was more than 6 months. No complications occurred after operation.
Induced LMH as a new treatment was effective in improving persistent CME from BRVO in most cases both anatomically and functionally.
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