Arteriovenous Sheathotomy for Persistent Macular Edema in Branch Retinal Vein Occlusion

Purpose: To evaluate the efficacy of arteriovenous (AV) sheathotomy with internal limiting membrane peeling for persistent or recurrent macular edema after intravitreal triamcinolone injection and/or laser photocoagulation in branch retinal vein occlusion. Methods: Twenty-two eyes with branch retinal vein occlusion (BRVO) with recurrent macular edema underwent vitrectomy with AV sheathotomy and internal limiting membrane peeling. All eyes had previous intravitreal triamcinolone injection and/or laser photocoagulation for macular edema. The best corrected visual acuity (BCVA), fluorescein angiography and optical coherence tomography (OCT) before and after surgery were compared. Results: The mean preoperative BCVA (log MAR) were 0.79 ±0.29 and postoperative BCVA (log MAR) at 3 months was 0.57±0.33. And improvement of visual acuity ≥2 lines was observed in 10 eyes (45%). The mean preoperative fovea thickness measured by OCT was 595.22±76.83 μm (510-737 μm) and postoperative fovea thickness was 217.60±47.33 μm (164-285 μm). Conclusions: Vitrectomy with AV sheathotomy can be one treatment option for the patients with recurrent macular edema in BRVO. Korean Journal of Ophthalmology 20(4):210-214, 2006