4th session: CVO/BVO

3-year results with arteriovenous decompression in branch retinal
vein occlusion
Ulrich Mester, P.
Dillinger (Sulzbach)
The actual concept of the pathomechanism of branch retinal vein occlusion
(BRVO)
is based on compression of the vein by the artery at the crossing site,
where both
vessels share a common wall. The logical therapeutic approach was the
dissection of
this adventitial sheath.
Methods: 129 eyes with BRVO were surgically treatet from August 1999
until August
2002 in our department. All eyes had a BCVA of 0.4 or less, and a history
of BRVO of
less than 3 months. Surgery consisted of a standard three port pars
plana vitrectomy
with ILM-peeling in the edematous macula and dissection of the sheeth
at the AV-crossing. Follow up was at
least 6 weeks. Fluoresceinangiograms were performed preoperatively
and 6 weeks postoperatively.
Results: BCVA improved from 0.18 (± 0.12) to 0.36 (± 0.24)
postoperatively. 63 % of patients gained at least
two, 41 % four lines or more. 7 eyes (5 %) lost two lines due to the
progression of cataract (5 eyes) or the development
of retinal detachment (2 eyes).
Conclusion: Surgical AV decompression combined with ILM-peeling off
the macula seems to be beneficial in
BRVO. Some open questions as the time window for the surgical intervention
may be answered in a just started
multicenter trial.
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