Non–Vitrectomizing Sheathotomy for Macular Edema in Branch Retinal Vein Occlusion

Abstract

Abstract: : Purpose: Non–vitrectomizing sheathotomy was performed in 3 cases of macular edema in branch retinal vein occlusion (BRVO), to evaluate the efficacy of sheathotomy without vitrectomy. Methods: Three eyes of 3 patients with posterior vitreous detachment underwent separation of the overlying artery from the vein without vitrectomy. Results: During surgery, vasodilation was observed on the medial side of the arteriovenous (A/V) crossing in 2 eyes. In these eyes, macular edema dissapeared between 2 and 4 months after the surgery. Both eyes showed an improvement in logMAR visual acuity by 2 lines or more following surgery. In the eye which was free of vascular dilation on the medial side of the A/V crossing during surgery, cystoid macular edema persisted and visual acuity deteriorated after surgery. Conclusions: In cases of macular edema in BRVO, sheathotomy without vitrectomy was found to be useful by facilitating early absorption of macular edema. Intraoperative vasodilation seems to serve as a factor in determining the prognosis after this surgery.

Keywords: vascular occlusion/vascular occlusive disease • vitreoretinal surgery • macula/fovea