Vitrectomy for macular edema combined with retinal vein occlusion

Tachi, Naoko; Hashimoto, Yoshihiro; Ogino, Nobuchika

doi:10.1007/978-94-011-4152-9_32

Cited by 42 publications

(79 citation statements)

References 2 publications

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“…As reported previously, vitrectomy reduces macular edema associated with branch retinal vein occlusion [1] , and it may have beneficial effects on retinal ischemia by allowing oxygenated fluid to circulate in the vitreous cavity [2] . Moreover, vitreomacular attachment has been suggested to be involved in persistent macular edema in eyes with branch retinal vein occlusion [1] .…”

Section: Discussionmentioning

confidence: 72%

“…Tachi et al [1] reported that vitrectomy reduced macular edema associated with branch retinal vein occlusion. Vitrectomy may have beneficial effects on retinal ischemia by allowing oxygenated fluid to circulate in the vitreous cavity [2] .…”

Section: Introductionmentioning

confidence: 99%

“…Vitrectomy may have beneficial effects on retinal ischemia by allowing oxygenated fluid to circulate in the vitreous cavity [2] . In addition, it has been suggested that vitreomacular attachment is involved in persistent macular edema in eyes with branch retinal vein occlusion [1] . Recently, triamcinolone acetonide (TA) was reported to be effective in treating macular edema associated with diabetic retinopathy, central retinal vein occlusion, uveitis, pseudophakia and exudative age-related macular degeneration [3][4][5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

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Comparative Study on Efficacy of a Combination Therapy of Triamcinolone Acetonide Administration with and without Vitrectomy for Macular Edema Associated with Branch Retinal Vein Occlusion

Hirano¹,

Sakurai²,

Yoshida³

et al. 2007

Ophthalmic Res

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Aims: To compare the efficacy ofa combination therapy of triamcinolone acetonide (TA) administration with and without vitrectomy in eyes with macular edema associated with branch retinal vein occlusion over a 1-year period. Methods: A retrospective, case-control study was conducted in 15 eyes of 15 patients with macular edema associated with branch retinal vein occlusion. Eight eyes underwent simultaneous intravitreal and posterior sub-Tenon capsule injections of TA (TA-injected group). Seven eyes underwent vitrectomy with intravitreal or simultaneous posterior sub-Tenon capsule injection of TA (vitrectomy with TA group). Macular thickness and visual acuity were measured before and at 1, 3, 6 and 12 months after the therapy. Results: Twelve months after the therapy, mean visual acuity improved significantly from baseline in both the TA-injected (p = 0.0069) and vitrectomy with TA groups (p = 0.0145). Macular thickness also improved significantly in both the TA-injected (p = 0.0065) and vitrectomy with TA groups (p = 0.0058). At 12 months after the therapy, there was no significant difference in visual acuity and macular thickness between the two groups (p = 0.3308 and 0.3711, respectively). At the early postoperative stage (1 and 3 months after the therapy), the central macular thickness in the TA-injected group was significantly less than that in the vitrectomy with TA group (p = 0.0140 and 0.0275, respectively); there was no significant difference in visual acuity between the two groups (p = 0.0796 and 0.3753, respectively). Conclusion: TA injection without vitrectomy was as effective as a combination therapy of TA injection with vitrectomy.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparative Study on Efficacy of a Combination Therapy of Triamcinolone Acetonide Administration with and without Vitrectomy for Macular Edema Associated with Branch Retinal Vein Occlusion

Hirano¹,

Sakurai²,

Yoshida³

et al. 2007

Ophthalmic Res

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“…A recent case-control study of branch retinal vein visual outcome by vitrectomy and arteriovenous sheathotomy compared to grid laser photocoagulation. 15 The mechanism by which improvement may occur after dissection of the artery from the retinal surface around an arteriovenous crossing site without surgical separation of the vessels remain speculative. Seitz 16 hypothesized that the initiating abnormality in venous occlusion is "not a thrombus, but a trophic disturbance" related to the anatomic structure of the arteriovenous crossing that occurs within a framework of systemic arteriosclerosis or hypertension.…”

Section: Resultsmentioning

confidence: 99%

Sheathotomy For Treatment Of Branch Retinal Vein Occlusion

2006

J Liaquat Uni Med Health Sci

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INTRODUCTIONBranch retinal vein occlusion (BRVO) is a common retinal vascular disorder, second only to diabetic retinopathy as a cause of retinal vascular disturbance. 1,2The interruption of venous flow in these eyes almost always occurs at a retinal arteriovenous intersection, where a retinal artery crosses a retinal vein.3 BRVO is three times more common than CRVO. Men and women are affected equally. 4,5 The artery nearly always is anterior to the vein.6 Several medical and surgical interventions have been proposed to treat BRVO. The Branch retinal vein occlusion study demonstrated that Argon laser Photocoagulation may reduce visual loss from persistent macular edema and retinal neovascularization. But, photocoagulation is infective for restoring blood flow.7 Pars plana vitrectomy with surgical separation of the retinal artery from the underlying retinal vein at the site of pathological arteriovenous crossing has been advocated as a potential treatment for a branch vein occlusion and associated visual loss. PATIENTS AND METHODSThis study was performed on 20 consecutive patients with a branch vein occlusion and secondary macular dysfunction who underwent arteriovenous crossing dissection with attempt surgical separation of the artery and vein. Inclusion criteria were visual acuity of 20/60 or worse, less than 10 month duration. Exclusion criteria were presence of other vasculopathies, previous Grid laser photocoagulation and vitreous hemorrhage or retinal neovascularization. The pre-operative data from the patients included age, sex, eyes affected, duration of symptoms, refraction and best corrected visual acuity measurement. All 20 eyes underwent indirect ophthalmoscopy, slit lamp examination including biomicroscopy of the vitreous and retina. Fundus photography and FFA were also The surgical procedure consisted of a pars plana vitrectomy with separation of posterior hyaloid. A Bent tipped MVR blade was used to dissect the overlying retinal artery free from the retinal surface immediately proximal and distal to the pathologic arteriovenous crossing site. The artery was usually approached from both sides using a stroking motion of the blade tip. By connecting the incision from both sides of the artery, the artery was freed from the retinal surface. Post-operative follow up was performed from 1-2 months, 3-4 months and more than 6 months (final follow up). Subsequent FFA was assessed at varying intervals post-operatively, most of which had been performed from 3 to 5 months after surgery. For statistical analysis, the un-paired t-test was used to determine statistical significance with an alpha of 0.05. RESULTSTwenty patients underwent a pars plana viterctomy and sheathotomy consecutively. Eleven patients were males and nine females. The mean age was 69 years (Range = 39-84 years). The median duration of symptoms of vision loss was 16 weeks (Range= 6-156 weeks). Post-operative follow up was 01 to 15 months. In all cases, the artery was located anterior to the retinal vein at affected anterior venous crossing. In...

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“…Vitrectomy without ILM peeling may provide resolution of macular edema by mechanically removing VEGF and other cytokines such as IL-6 from the vitreous cavity and by enhancing oxygen transport to the hypoxic retina [40,41] . Tachi et al [42] suggested that early vitrectomy may be recommended for retinal vein occlusion associated with macular edema in the patients with BRVO and CRVO. In the study, they showed statistically significant visual improvement by performing PPV.…”

Section: Vitrectomy With or Without Internal Limiting Membrane (Ilm) mentioning

confidence: 99%

Fibrinolytic and Surgical Treatment Approaches for Retinal Vein Occlusion

Tekin¹,

Teke²,

İnanç³

2016

International Journal of Ophthalmic Research

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Retinal vein occlusion (RVO) is the second most common vascular disease after diabetic retinopathy. Although its high frequency, mechanisms underlying RVO and optimal treatment strategies are still controversial. There are various treatment modalities for retinal vein occlusion including observation, systemic treatments, intravitreal agents, laser photocoagulation, fibrinolytic treatment and surgical approaches. Despite most of the treatment strategies are directed at secondary complications of RVO that affect vision including macular edema and retinal neovascularization, some treatment options also have the ability to create a bypass around the obstructed retinal vein and to decrease the raised venous hydrostatic pressure. The aim of this review is to describe the outcomes of fibrinolytic and surgical treatment modalities for RVO.

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Vitrectomy for macular edema combined with retinal vein occlusion

Cited by 42 publications

References 2 publications

Comparative Study on Efficacy of a Combination Therapy of Triamcinolone Acetonide Administration with and without Vitrectomy for Macular Edema Associated with Branch Retinal Vein Occlusion

Comparative Study on Efficacy of a Combination Therapy of Triamcinolone Acetonide Administration with and without Vitrectomy for Macular Edema Associated with Branch Retinal Vein Occlusion

Sheathotomy For Treatment Of Branch Retinal Vein Occlusion

Fibrinolytic and Surgical Treatment Approaches for Retinal Vein Occlusion

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