AV-DEKOMPRESSION

Ulrich Mester (Sulzbach)

Purpose: Our therapeutical armamentarium for functional improvement after branch retinal vein occlusion (BRVO) is still limited with uncertain efficacy. Recently some surgeons proposed the surgical decompression of the vein at the arteriovenous crossing.

Methods: 43 patients with BRVO were treated in our department from August 1999 to April 2001 with AV-decompression. 25 patients with comparable BRVO who refused this surgical intervention served as a control group.

The surgical procedure consisted in a standard pars plana vitrectomy and separation of the overlying artery from the vein using microscissors. In 16 cases dissection of the internal limiting membrane (ILM) was performed additionally.

Assessment of visual acuity, fluorescein angiography and multifocal ERG in 7 patients was performed pre-operatively and 6 weeks after surgery.

Results: Surgical procedure and postoperative course were uneventful. In most of the treated eyes visual acuity improved and fluorescein angiography revealed capillary reperfusion. Functional results in patients with AV-decompression were highly significantly better than in the control group. Furthermore, the removal of the ILM seems to have an additional beneficial effect on the functional outcome.

Conclusion: Our results demonstrate the therapeutical effect of surgical AV-decompression in BRVO. Additional removal of the ILM seems to improve the functional results. Further experience may answer some still open questions.


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