Evaluation of arteriovenous crossing sheathotomy for decompression of branch retinal vein occlusion

Abstract

Purpose To report the effects of arteriovenous adventitial sheathotomy on anatomical and functional improvements in patients with macular oedema due to branch retinal vein occlusion (BRVO).

Methods Pars plana vitrectomy and arteriovenous sheathotomy was performed on 11 patients with BRVO who had vision loss due to macular oedema. Ten patients with macular oedema due to BRVO and who have been treated with grid laser photocoagulation were included in the control group. The measurement of visual acuity with ETDRS chart was taken preoperatively and at 1, 3, 6, and 9 months follow-up in the study group and at 1, 3, 6, and 9 months after grid laser in the control group.

Results The mean preoperative logMAR visual acuity was 0.84 +/- 0.3 in the surgical group and 1.06 +/- 0.4 in the control group. The postoperative mean logMAR visual acuity was 0.41 +/- 0.2, 0.40 +/- 0.2, 0.40 +/- 0.3, and 0.36 +/- 0.3 at 1, 3, 6, and 9 months follow-up, respectively. In the control group the postlaser mean logMAR visual acuity was 0.92 +/- 0.3, 0.87 +/- 0.4, 0.85 +/- 0.3, and 0.82 +/- 0.3 at 1, 3, 6, and 9 months follow-up, respectively. The improvements of visual acuity in both groups were statistically significant when compared to pretreatment (P=0.003 and P=0.007 at 9 months in the study and control group, respectively).

Conclusion Arteriovenous sheathotomy for decompression of BRVO in patients who have vision loss due to macular oedema was safe and effective for anatomical and functional improvement and resulted in significantly better visual outcomes than a matched control group of laser-treated eyes.