Abstract
Abstract: :
Purpose:Pars plana vitrectomy (PPV) along with other maneuvers have been reported to be useful for eyes with ischemic central retinal vein occlusion (CRVO) such as: radial optic neurotomy, retinochoroidal anastomosis and retinal endovascular surgery. As PPV was performed in all techniques we evaluated a only vitrectomy with posterior hyaloid removal in ischemic central retinal vein occlusion (a control group study) Methods: Prospective, longitudinal, experimental and descriptive study in patients with ischemic CRVO with visual acuity (VA) <20/100 or those whose VA decreased more than 50% during follow–up, an area over 10 disc diameter of nonperfused retina, and afferent pupillary defect. Eyes with rubeosis or previous laser treatment were excluded. All patients underwent vitrectomy with complete posterior hyaloid removal. Rubeosis, intraocular pressure (IOP), visual acuity and macular edema were evaluated clinically. Multifocal ERG (m–ERG), fluorescein angiography (FA) and optic coherence tomography (OCT), were also performed. Follow–up was at least 6 months. Results: 9 eyes were evaluated. Age ranged from 56 to 75 years, (average 66.14 years).7 (71.43%) were male. 57.14% presented past medical history of Type 2 Diabetes Mellitus and 42,86% systemic hypertension. Moderate improvement of visual acuity was observed in 57.14% eyes and stabilized in 42.86%. IOP changed from 14.42 ± 2.7 mmHg to 13.86 ± 2.48 mmHg post–operative. 2 eyes presented rubeosis iridis 6 months after treatment and vitreous hemorrhage that resolved after air–fluid exchange and panretinal photocoagulation. Macular edema was evaluated with OCT: Pre–operative average was 1012 ± 158 mm; first month post–operative was 767 ± 290 mm and third months 652 ± 275 mm. Macular edema, mERG, FA, and OCT showed improvement until the last day of follow up. Conclusions:: Vitrectomy with complete posterior hyaloid removal for treatment of ischemic CRVO appears to be an effective measure to achieve improvement and/or stabilization of VA with minimal complications
Keywords: vascular occlusion/vascular occlusive disease • vitreoretinal surgery • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)