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F. Becquet, J. Le Rouic, D. Ducournau; A Prospective Study of Surgical Treatments for Branch and Central Retinal Vein Occlusion . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3021.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the results of internal limiting membrane (ILM) removal in macular edema due to branch retinal vein occlusion (BRVO) and radial optic neurotomy (RON) in severe central retinal vein occlusion (CRVO). Methods: For BRVO with a decreased visual acuity of 20/40 or less due to macular edema, vitrectomy with ILM peeling was performed on 8 eyes of 8 consecutive patients. ILM peeling associated with arteriovenous crossing sheathotomy was performed on 7 eyes of 7 consecutive patients. For CRVO, RON was performed on 20 eyes of 20 consecutive patients with visual acuities of 20/200 or less. In this non-randomized prospective study, ETDRS visual acuity, fluorescein angiography, automated perimetry, and OCT were realized for each patient pre and postoperatively (at 3 and 6 months). Results: Surgery was performed successfully in all 35 patients. No postoperative complications were noted. At 6 months, an improved visual acuity was observed in all patients with BRVO with an average gain of three lines of vision (p = 0.002); and in 85% of patients with CRVO with an average gain of four lines of vision (p = 0.03). Fluorescein angiography and automated perimetry were improved in all patients. Compared to preoperative one, mean postoperative foveal thickness consistently decreased for patients with BRVO (419 vs 233 microns; p = 0.02) and CRVO (580 vs 361 microns; p = 0.03). For patients with BRVO, no difference was noted between ILM peeling alone and ILM peeling with arteriovenous crossing sheathotomy in terms of visual acuity, visual field, or foveal thickness improvement. Conclusions: Our findings suggest that RON for CRVO and ILM removal for macular edema complicating BRVO may improve functional prognosis in patients with retinal vein occlusion compared to their natural history.
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