Abstract
Abstract: :
Purpose:To examine the morphological and functional changes after arteriovenous (A/V) crossing sheathotomy for macular edema associated with branch retinal vein occlusion (BRVO). Methods:Adventitial sheathotomy at an A/V crossing was performed in 14 eyes of 14 patients (AS group) with BRVO-associated macular edema. Simple posterior vitreous detachment was created in 10 eyes of 10 patients (PVD group) with BRVO-associated macular edema. The postoperative follow-up period was more than 6 months in all cases. The visual acuity (log MAR), macular multifocal electroretinograms (mfERGs), and optical coherence tomography (OCT)-determined foveal thickness were examined preoperatively, and at 1, 3, and 6 months postoperatively. Results:Preoperative visual acuity was 0.55±0.38 (mean±SD) in the AS group, and 0.61±0.46 in the PVD group. In the AS group, the visual acuity was 0.61±0.31 at 1 month, 0.48±0.38 at 3 months, and 0.32±0.24 at 6 months, postoperatively. In the PVD group, the visual acuity was 0.54±0.37 at 1 month, 0.48±0.43 at 3 months, and 0.30±0.48 at 6 months. No significant difference was observed between two groups at any postoperative times. The foveal thickness was 690±189 µm in the AS group preoperatively and was significantly reduced to 302 µm at 1 month (P=0.0004) and to 236 µm at 6 months after surgery. In the PVD group, the foveal thickness was 527±127 µm preoperatively, and was reduced to 425±76 µm at 1 month, and 247±64 µm at 6 months postoperatively (P=0.005, as compared with preop). The macular mfERGs improved gradually in both groups postoperatively, however, the improvement was greater in the PVD eyes than in the AS eyes at any follow up point (P<0.05). Conclusion:Adventitial sheathotomy at an A/V crossing improved the macular edema associated with BRVO more quickly than the simple PVD formation. However, there was no significant difference in the improvement of macular function between two surgical procedures. Further studies will be needed to evaluate the efficacy for the A/V crossing sheathomy.
Keywords: 615 vascular occlusion/vascular occlusive disease • 353 clinical (human) or epidemiologic studies: outcomes/complications • 628 vitreoretinal surgery