Abstract
Purpose: :
To evaluate whether a free radical scavenger, edaravone, can be used to rescue sensory retinal cells from free radical toxicity by ischemia–reperfusion after arteriovenous sheathotomy for treatment of macular edema associated with branch retinal vein occlusion (BRVO).
Methods: :
Forty–nine consecutive patients (49 eyes) with BRVO treated with arteriovenous sheathotomy were analysed. All patients had both macular edema and intraretinal hemorrhage. The preoperative visual acuity was worse than 20/40. First consecutive 32 patients were administrated 30mg of edaravone (Radicut®) by intravenous route during vitrectomy (Group R), and following consecutive 17 patients were administrated physiological saline in the same way (Group N). On the day 1 and 2 after the surgery, edaravone or saline was given by intravenous route to each group in the same manner as before once a day. All patients were followed postoperatively for a mean of 8.4 months.
Results: :
The average age, the presumable time after onset, and the best–corrected visual acuity before surgery were not statistically significant difference between two groups. The best–corrected visual acuity of LogMAR improved from 0.20 to 0.46 in Group R, from 0.20 to 0.25 in Group N. Twenty–six of 32 cases (81%) in Group R, 5 of 17 cases (29%) in Group N, have improved their best–corrected visual acuity 2 lines or more (p<0.001).
Conclusions: :
Arteriovenous sheathotomy, surgical venous decompression procedure, may reperfuse the retinal vein in the ischemic area. Free radical, it may be the cause of retinal cell damage, will be produced after re–circulation of the vein. Edaravone, free radical scavenger, can remove these free radical from the retina. Our data indicated that the patients have received edaravone administration had better visual acuity after arteriovenous sheathotomy. These results suggest that the free radical scavenger can rescue sensory retinal cells after arteriovenous sheathotomy.
Keywords: retina • ischemia • drug toxicity/drug effects