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H. Yamaji, F. Shiraga, Y. Tsuchida, H. Ohtsuki, Y. Yamamoto; Evaluation of Arteriovenous Crossing Sheathotomy for Branch Retinal Vein Occlusion by Fluorescein Videoangiography and Image Analysis . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3016.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:We quantitatively evaluated the effects of arteriovenous (A/V) crossing sheathotomy on retinal circulation in patients with branch retinal vein occlusion (BRVO) accompanied by macular edema.Methods:In 18 consecutive patients (18 eyes) with BRVO accompanied by macular edema, who underwent A/V crossing sheathotomy between August 1999 and April 2002, changes in circulation after the surgery were evaluated by fluorescein videoangiography with a scanning laser ophthalmoscope and by image analysis using dye dilution technique. At a venule distal to the responsible A/V crossing site and a normal venule, the circulation time (T50) from the beginning of filling to 50% filling of the peak intensity was calculated. The time difference (ΔT50) between the two points, which represents the delay in filling on the point distal to the A/V crossing site, was compared between before and early after the surgery. Results:The preoperative ΔT50 was 1.36 ± 1.15 sec (mean ± SD), and the postoperative ΔT50 was 0.72 ± 0.77 sec (p = 0.035). In 11 of the 18 eyes, ΔT50 decreased by 20% or more after operation. In the other 7 eyes, ΔT50 was unchanged or slightly increased after the surgery. Conclusions:Though a randomized controlled study is needed to confirm the effectiveness of A/V crossing sheathotomy on visual function, this technique could be effective for improving the delay in perfusion in the occluded venule, depending on the timing of surgery and the case selection.
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