Abstract
Purpose: :
To evaluate whether the reperfusion of the occluded retinal vein shown by measurement of the blood flow volume using the Laser Speckle Flowgraphy (LSFG) can reduce the macular edema and improve the best-corrected visual acuity (BCVA) after arteriovenous sheathotomy in eyes with branch retinal vein occlusion (BRVO).
Methods: :
Recently we suggested that LSFG might be useful to evaluate quantitatively that the procedure of arteriovenous sheathotomy decompresses the mechanical pressure in the arteriovenous crossing site of BRVO and can improve the blood flow volume in the retinal vein (2008 ARVO meeting). Six eyes of 6 patients with BRVO who were treated with arteriovenous sheathotomy and could gain vein dilatation were analyzed. None of the patients were given triamcinolone acetonide during surgery. Two measurement points by LSFG were selected at the retinal vein proximal to the arteriovenous crossing site and the non-affected retinal vein. The relative flow volume, expressed with mean blur rate (MBR) was measured by LSFG within 24 hours before the surgery, on 7 days and 1 year after the surgery. In all patients, the BCVA in logMAR units and macular edema evaluated by OCT were measured before and 1 year after the surgery.
Results: :
In all cases, at 7 days after the surgery, the blood flow volume of the vein in which arteriovenous sheathotomy was performed and showed increase in comparison to before the surgery. At 1 year postoperatively, there was a decrease in the macular edema in all eyes, and 5 of 6 eyes had an improvement in the VA=0.2logMAR units.
Conclusions: :
Reperfusion of venous blood flow after arteriovenous sheathotomy lead to reduce the macular edema associated with BRVO and improve the BCVA 1 year after the surgery. The measurement of the blood flow volume using the LSFG on 7days after surgery can be an index of long-term prognosis.
Keywords: imaging/image analysis: clinical • vascular occlusion/vascular occlusive disease • vitreoretinal surgery