Abstract Vitreoretinal Symposium Frankfurt / Marburg 2003
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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