Faculty Collaboration Database

Arteriovenous crossing dissection without separation of the retina vessels for treatment of branch retinal vein occlusion. Retina 2003 Apr;23(2):145-51

Date

04/23/2003

Pubmed ID

12707591

DOI

10.1097/00006982-200304000-00002

Scopus ID

2-s2.0-0037656160 (requires institutional sign-in at Scopus site)   29 Citations

Abstract

PURPOSE: To evaluate visual outcome after arteriovenous (AV) crossing dissection for the treatment of branch retinal vein occlusion (BRVO) and secondary macular dysfunction in which difficulty separating the retinal vessels was experienced.

METHODS: A pars plana vitrectomy and dissection of the involved AV crossing site were performed consecutively in 20 eyes of 20 patients with BRVO and vision loss. The overlying retinal artery was dissected free from the retinal surface, and separation of the artery and vein at the crossing site was attempted.

RESULTS: In 19 of 20 eyes, the retinal artery was dissected around the crossing site, but a marked adhesion between the artery and vein precluded separation. After a mean follow-up of 10.5 months, VA improved by at least two lines in 16 eyes (80%), remained unchanged in three eyes (10%), and worsened by at least two lines in three eyes (10%). Mean change (+/- SE) in logMAR acuity was -0.28 +/- 0.11 (two or three lines of improvement, P = 0.016) at 1 to 2 months' follow-up and -0.44 +/- 0.14 (three or four lines of improvement, P = 0.008) at the final follow-up. Cataract formation or progression occurred in 88%.

CONCLUSIONS: A surgically important adhesion between the retinal artery and vein at proximal AV crossings was encountered in all eyes undergoing AV crossing dissection, correlating with previous histologic and cadaver eye studies. Cataract formation or worsening was a frequent complication. Visual improvement may occur after vitrectomy and AV crossing dissection without separation of the retinal vessels.

Author List

Han DP, Bennett SR, Williams DF, Dev S

Author

Dennis Han MD Emeritus Professor in the Ophthalmology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Macular Edema
Male
Middle Aged
Ophthalmologic Surgical Procedures
Postoperative Period
Retinal Artery Occlusion
Retrospective Studies
Time Factors
Treatment Outcome
Visual Acuity
Vitrectomy