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Branch retinal vein sheathotomy

Christine N Kay, Kori A Elkins, James C Folk
PURPOSE: To report a case of a woman with a branch vein occlusion and macular edema refractory to grid laser, intravitreal bevacizumab, pars plana vitrectomy with sheathotomy of the arteriovenous branch site, and intravitreal triamcinolone, who had complete resolution of fluid after injection of a dexamethasone intravitreal implant (DEX implant, Ozurdex; Allergan, Inc, Irvine, CA). METHODS: A 75-year-old woman with a branch vein occlusion and macular edema was treated with grid laser, intravitreal bevacizumab, pars plana vitrectomy with sheathotomy, and intravitreal triamcinolone...
2012: Retinal Cases & Brief Reports
T Bertelmann, I Bertelmann, P Szurman, U Mester, J Schmidt, W Sekundo, S Mennel
PURPOSE: The aim of this study was to evaluate whether the adhesion status of the posterior vitreous cortex (PVC) towards the internal limiting membrane (ILM) has an impact on the development of retinal vein occlusion (RVO). MATERIAL AND METHODS: In a retrospective analysis the operation protocols of 238 eyes receiving pars plana vitrectomy (ppV) and radial optic neurotomy (RON) for central retinal vein occlusion (CRVO) or ppV in combination with arteriovenous sheathotomy (AVS) for branch retinal vein occlusion (BRVO) were evaluated with respect to the intraoperative status of posterior vitreous body adhesion...
December 2014: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Shin Yamane, Motohiro Kamei, Susumu Sakimoto, Maiko Inoue, Akira Arakawa, Mihoko Suzuki, Nagakazu Matsumura, Kazuaki Kadonosono
BACKGROUND: The purpose of this study was to evaluate visual outcomes of arteriovenous sheathotomy for macular edema due to branch retinal vein occlusion (BRVO). METHODS: The medical records of 45 eyes from 45 patients who had undergone vitrectomy surgery with arteriovenous sheathotomy for BRVO were studied. Forty-five eyes of 45 patients with a BRVO but without intervention were studied as the control group. The best-corrected visual acuity and central macular thickness were compared between the two groups at baseline and at 1, 3, 6, and 12 months postoperatively...
2014: Clinical Ophthalmology
Irini P Chatziralli, Adil Jaulim, Vasileios G Peponis, Panagiotis G Mitropoulos, Marilita M Moschos
BACKGROUND: Retinal vein occlusion is the second most common retinal vascular disorder after diabetic retinopathy and is considered to be an important cause of visual loss. In this review, our purpose is to update the literature about the treatment alternatives for branch retinal vein occlusion. METHODS: Eligible papers were identified by a comprehensive literature search of PubMed, using the terms "branch retinal vein occlusion," "therapy," "intervention," "treatment," "vitrectomy," "sheathotomy," "laser," "anti-VEGF," "pegaptanib," "bevacizumab," "ranibizumab," "triamcinolone," "dexamethasone," "corticosteroids," "non-steroids," "diclofenac," "hemodilution," "fibrinolysis," "tPA," and "BRVO...
March 2014: Seminars in Ophthalmology
John C Hwang, Susan K Gelman, Howard F Fine, Stanley Chang, Lucian V Del Priore
PURPOSE: To describe the treatment of macular oedema secondary to branch retinal vein occlusion (BRVO) with concomitant pars plana vitrectomy/arteriovenous sheathotomy and intraoperative intravitreal triamcinolone acetonide. METHODS: Retrospective case series. RESULTS: Four eyes of four patients were identified. Patients improved from a mean best-corrected visual acuity of 20/124 at baseline to 20/122 at month 1, 20/83 at month 3, 20/74 at month 6, 20/59 at month 9 and 20/44 at month 12 (p = 0...
November 2010: British Journal of Ophthalmology
Mahiul M K Muqit, Shohista Saidkasimova, David Keating, John R Murdoch
PURPOSE: To evaluate the perfusion effects and long-term visual outcome of pars plana vitrectomy (PPV) combined with arteriovenous sheathotomy (AVS) with or without triamcinolone for nonischaemic branch retinal vein occlusion (NI-BRVO). METHODS: Prospective, interventional case series of eight patients with NI-BRVO and haemorrhagic macular oedema. Patients underwent PPV and AVS (n = 5), or PPV, AVS and intravitreal triamcinolone (IVT, n = 3). A masked grading technique assessed fundus photographs and fluorescein angiography (FFA) following surgery...
May 2010: Acta Ophthalmologica
S G Toropygin
The review provides an update on the surgical management of branch retinal vein occlusion. Arteriovenous sheathotomy is shown to be the only clinically evaluated and approved technique for surgical decompression of occluded retinal vein; it is based on indirect mechanical effect of reducing external vascular compression to improve the blood flow. Despite visual improvement in some patients, capillary reperfusion was not always achieved. Results of our own experimental studies are described to substantiate the use of a low-energy near-infrared Ti:Sapphire femtosecond laser for direct non-mechanical destruction of thrombotic material to immediately restore the blood flow in retinal vein...
2009: Vestnik Rossiĭskoĭ Akademii Meditsinskikh Nauk
T Maeno, R Tano, H Takenaka, T Mano
AIMS: To determine whether edaravone (MCI-186), a free radical scavenger, can reduce macular oedema and improve the visual acuity after arteriovenous sheathotomy in eyes with a branch retinal vein occlusion (BRVO). METHODS: Forty-seven eyes of 47 consecutive patients with a BRVO who were treated with arteriovenous sheathotomy were studied. The patients were assigned prospectively to either Group R who received 30 mg of edaravone (Radicut) systemically during the vitrectomy or Group N who did not receive any drugs...
November 2009: British Journal of Ophthalmology
B M Stoffelns, C Kramann, K Schoepfer
BACKGROUND: The aim of this study is to report on arteriovenous sheathotomy in branch retinal vein occlusion (BRVO) with a long-term follow-up and examine the visual field effects of this surgical approach. PATIENTS AND METHODS: In a clinical trial 36 eyes with branch retinal vein occlusion (22 eyes with ischaemia, 14 eyes with chronic macular oedema) underwent surgical decompression accompanied by peeling of the membrana limitans interna after prior isovolemic haemodilution for 3 months had been unsuccessful...
April 2009: Klinische Monatsblätter Für Augenheilkunde
Maurizio Battaglia Parodi, Francesco Bandello
Branch retinal vein occlusion (BRVO) refers to a heterogeneous group of disorders with different clinical aspects, courses, and probably therapy. Depending on the site of the arteriovenous crossing, we can roughly divide BRVO into 3 main groups: major BRVO, hemispheric retinal vein occlusion, and macular BRVO. Main treatment options include laser treatment, corticosteroid administration, anti-VEGF drugs, and sheathotomy with or without vitrectomy. Laser photocoagulation, as demonstrated by the Branch Vein Occlusion Study, represents the gold standard for the treatment of macular edema and ocular neovascularization following BRVO...
2009: Ophthalmologica. Journal International D'ophtalmologie
Gary Edd Fish
PURPOSE: To compare intravitreous bevacizumab to other current treatments of branch retinal vein occlusion (BRVO) and hemisphere retinal vein occlusion (HRVO) with consideration to visual outcome, cost, convenience, and risk of treatment. METHODS: This is a retrospective chart review from a large referral retina practice. The data comprise 56 patients with BRVO and HRVO treated by intravitreous bevacizumab, with and without intravitreous triamcinolone acetonide...
2008: Transactions of the American Ophthalmological Society
Sadaf Hamid, Sajid Ali Mirza, Ishrat Shokh
OBJECTIVE: To determine the relative position of the two vessels at the site of venous obstruction, as it facilitates Arteriovenous adventitial sheathotomy and to look for the associated diseases with branch retinal vein occlusion (BRVO) so as to create more awareness among the masses. METHODS: It was a case series carried out at the Ophthalmology out-patient department of Ziauddin University Hospital Karachi, Pakistan, from April 2005 to March 2006. The diagnosis of BRVO was made on the clinical basis...
May 2008: JPMA. the Journal of the Pakistan Medical Association
Eun Jee Chung, Hyo Lee, Hyoung Jun Koh
PURPOSE: To compare the functional and anatomical outcomes of arteriovenous (AV) sheathotomy and intravitreal triamcinolone acetonide (IVTA) injection in the treatment of macular edema associated with branch retinal vein occlusion (BRVO). METHODS: Forty eyes of 40 patients with macular edema secondary to BRVO were randomized into two treatment groups. A total of 20 patients received AV sheathotomy (sheathotomy group), and the second group of 20 patients was treated with IVTA (IVTA group)...
July 2008: Graefe's Archive for Clinical and Experimental Ophthalmology
In Kyung Oh, Sungwoo Kim, Jaeryung Oh, Kuhl Huh
PURPOSE: To evaluate long-term visual outcome of arteriovenous adventitial sheathotomy in BRVO-induced macular edema. METHODS: The visual outcomes of 8 patients following vitrectomy with arteriovenous adventitial sheathotomy for BVO-induced macular edema (surgery group) were retrospectively evaluated. The three-year post-operative visual acuity of the surgery group was compared with that of the conservatively managed controls. RESULTS: All patients were followed for a minimum of 36 months...
March 2008: Korean Journal of Ophthalmology: KJO
Eun Jee Chung, William R Freeman, Hyoung Jun Koh
PURPOSE: To evaluate the influence of arteriovenous (AV) sheathotomy on retinal function with central multifocal electroretinography (mfERG) in eyes with macular edema secondary to branch retinal vein occlusion (BRVO). METHODS: Fifteen patients (15 eyes) who underwent AV sheathotomy for macular edema secondary to BRVO were included in the study. Best-corrected visual acuity and mfERG responses from the most central seven hexagons were analyzed before and 6 months after the operation...
February 2008: Retina
Jiri Rehak, Matus Rehak
In branch retinal vein occlusion (BRVO), abnormal arteriovenous crossing with vein compression, degenerative changes of the vessel wall and abnormal hematological factors constitute the primary mechanism of vessel occlusion. In general, BRVO has a good prognosis: 50-60% of eyes are reported to have a final visual acuity (VA) of 20/40 or better even without treatment. One important prognostic factor for final VA appears to be the initial VA. Grid laser photocoagulation is an established treatment for macular edema in a particular group of patients with BRVO, while promising results for this condition are shown by intravitreal application of steroids or new vascular endothelial growth factor inhibitors...
February 2008: Current Eye Research
Masahiko Shimura, Toru Nakazawa, Kanako Yasuda, Hiroshi Kunikata, Takashi Shiono, Kohji Nishida
PURPOSE: To investigate the relationship between vitreous levels of cytokines, including interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF), and visual prognosis after pars plana vitrectomy (PPV) with arteriovenous sheathotomy in patients with branch retinal vein occlusion (BRVO) associated with macular oedema. METHODS: We studied 60 patients with logMAR visual acuity (VA) scores of < 0.3 and visual impairment secondary to BRVO-associated macular oedema...
June 2008: Acta Ophthalmologica
Sven Crafoord, Niklas Karlsson, Morten la Cour
PURPOSE: To report the clinical experience and results of using a microsurgical technique to decompress the arteriovenous connection in complicated branch retinal vein occlusion (BRVO) combined with haemorrhage, oedema and ischaemia. METHODS: We carried out a retrospective, non-randomized, interventional case study of the surgical sheathotomy decompression procedure. We enrolled 12 patients (seven women, five men; median age 64 years) with BRVO and decreased visual acuity (VA) caused by haemorrhage, oedema and ischaemia...
March 2008: Acta Ophthalmologica
A E Höh, K B Schaal, S Dithmar
BACKGROUND: The main object of this study was to find out what treatment methods are currently preferred for central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) in Germany, Austria and Switzerland. METHODS: A questionnaire concerning the different medicamentous, surgical and laser treatments available for CRVO and BRVO was developed and sent out to the members of the German Retina Society. RESULTS: This analysis is based on 124 returned questionnaires...
April 2007: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
N Feltgen, H Agostini, L Hansen
The range of therapeutic options for the treatment of retinal vein occlusions has been decisively extended by three new surgical methods: radial optic neurotomy (RON) and retinal endovascular lysis (REVL) for central retinal vein occlusion, and arteriovenous dissection (AVD/sheathotomy) for branch retinal vein occlusion. None of those methods has been tested in randomised studies meeting the requirements of evidence-based medicine. It is therefore difficult to assess the relative values of the individual procedures and determine in what precise circumstances each is indicated...
April 2007: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
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