Sheathotomy in complicated cases of branch retinal vein occlusion

• Purpose: To report the clinical experience and results of using a microsurgical technique to decompress the arteriovenous connection in complicated branch retinal vein occlusion (BRVO) combined with haemorrhage, oedema and ischaemia.Methods: We carried out a retrospective, non-randomized, interventional case study of the surgical sheathotomy decompression procedure. We enrolled 12 patients (seven women, five men; median age 64 years) with BRVO and decreased visual acuity (VA) caused by haemorrhage, oedema and ischaemia. The mean duration of thrombosis was 7 months (2–15 months). The patients were examined for pre- and postoperative best corrected VA (BCVA), intraocular pressure (IOP) and fundus photography. Ten patients were examined with fluorescein angiography and eight with ocular coherence tomography (OCT). Postoperative progression of cataract was recorded, as were other complications. The mean follow-up time was 20 months (8–39 months).Results: Best corrected VA had improved in nine patients, was unchanged in one patient and had deteriorated in two patients at the last follow-up. Noted complications were venous haemorrhage at surgery in five patients, retinal detachment in one patient and progression of cataract in four patients.Conclusions: Microsurgical treatment with sheathotomy of BRVO is a technically feasible procedure with few complications. Postoperative increased reperfusion could explain the resolution of macular haemorrhage, oedema and ischaemia, and may improve visual function in patients with this common vascular eye disease.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Oftalmologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Ophthalmology (hsv//eng)

Keyword

Aged

Cataract/complications/physiopathology

Decompression; Surgical/adverse effects/*methods

Disease Progression

Feasibility Studies

Female

Follow-Up Studies

Humans

Ischemia/complications

Macula Lutea

Macular Edema/complications/diagnosis

Male

Microsurgery/adverse effects/methods

Middle Aged

Retinal Detachment/etiology

Retinal Diseases/*complications

Retinal Hemorrhage/complications/etiology

Retinal Vein Occlusion/*complications/physiopathology/*surgery

Retinal Vessels

Retrospective Studies

Tomography; Optical Coherence

Visual Acuity

MEDICINE

MEDICIN

Ophtalmology

Oftalmologi

Medicine

Medicin

Publication and Content Type

ref (subject category)

art (subject category)