Management of branch retinal vein occlusion with vitrectomy and arteriovenous adventitial sheathotomy, the possible role of surgical posterior vitreous detachment

Charbonnel, J.; Glacet–Bernard, A.; Korobelnik, Jean‐François; Nyouma-Moune, Emilienne; Pournaras, Constantin J.; Colin, Joseph; Coscas, G.; Soubrane, G.

doi:10.1007/s00417-003-0824-4

Cited by 68 publications

(57 citation statements)

References 21 publications

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“…Interestingly, there were no differences found regarding either parameter between both groups, indicating that induction of a PVD has the same beneficial effect than a vitrectomy plus arteriovenous sheatotomy in eyes with a history of branch retinal vein occlusion [48]. Charbonnel et al [49] showed that in eyes with an initial PVD prior to surgery VA worsened postoperatively whereas eyes with an attached posterior vitreous experienced a statistically significant gain in VA after vitrectomy. The author suggested as a conclusion that ‘the surgical detachment of the posterior hyaloid could be as important (or more) as the sheatotomy itself' [49].…”

Section: Discussionmentioning

confidence: 99%

Intravitreal Functional Plasminogen Is Elevated in Central Retinal Vein Occlusion

Bertelmann

Mennel²,

Sekundo³

et al. 2013

Ophthalmic Res

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Purpose: To detect intravitreal functional plasminogen in vitreous samples of patients with recent onset of central retinal vein occlusion (CRVO) and to demonstrate significantly higher intravitreal plasminogen in CRVO patients in comparison to controls. Methods: Prospective clinical case series of 13 consecutive patients with recent onset of CRVO scheduled for core pars plana vitrectomy and 10 consecutive patients undergoing standard pars plana vitrectomy for routine macular surgery or vitreal floater removal. In all 23 cases, vitreous taps were extracted from the central vitreous body, and plasminogen was functionally determined in a new ultrasensitive p-nitroanilide reaction after activation with streptokinase (100% of normal, %N = functional plasminogen in pooled normal citrated plasma). Results: Plasminogen was detected in all analyzed samples (n = 23), and mean plasminogen was revealed to be 1.33 ± 1.73% (mean ± SD), with a range of 0.03-7.8%N. Patients with recent onset of CRVO exhibited significantly higher intravitreal plasminogen (2.19 ± 1.89%N) in comparison to controls (0.20 ± 0.21%N; p < 0.001, Mann-Whitney U test). Conclusion: Due to significantly increased intravitreal plasminogen in patients with recent onset of CRVO, intravitreally administered tissue plasminogen activator might be an option to induce posterior vitreous detachment (enzymatic vitreolysis) in CRVO patients.

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Section: Discussionmentioning

confidence: 99%

Intravitreal Functional Plasminogen Is Elevated in Central Retinal Vein Occlusion

Bertelmann

Mennel²,

Sekundo³

et al. 2013

Ophthalmic Res

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“…The results of sheathotomy in eyes with posterior vitreous detachment developed previously were not as good as those of the eyes without posterior vitreous detachment before surgery. 21 Nonetheless, the existence or absence of posterior vitreous detachment was not a criterion; no posterior vitreous detachment was encountered and posterior vitreous cortex was separated intraoperatively in our study.…”

Section: Discussionmentioning

confidence: 52%

“…To analyse and compare the studies on sheathotomy is difficult because of differences and variations of methodology. [8][9][10][11][12][13][14][15][16][21][22][23][24][25][26][27][28][29][30] No control group that has similar conditions could have been created in the majority of the reported studies. Some case reports have shown favourable results while others have not.…”

Section: Discussionmentioning

confidence: 99%

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

Avcı

İnan

Kaderli

2006

Eye

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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 0.8470.3 in the surgical group and 1.0670.4 in the control group. The postoperative mean logMAR visual acuity was 0.4170.2, 0.4070.2, 0.4070.3, and 0.3670.3 at 1, 3, 6, and 9 months follow-up, respectively. In the control group the postlaser mean logMAR visual acuity was 0. 9270.3, 0.8770.4, 0.8570.3, and 0.8270.3 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 ¼ 0.003 and P ¼ 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.

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“…Nevertheless, some studies comparing vitrectomy alone with vitrectomy associated with sheathotomy have pointed out the absence of any difference in the clinical outcomes [79, 80]. Thus, it is possible that the key role in this surgery is played by the simple vitrectomy [82]. Pars plana vitrectomy with the creation of a posterior vitreous detachment was previously found to lead to a reduction in ME and a functional improvement in BRVO [83,84,85].…”

Section: Treatmentmentioning

confidence: 99%

Branch Retinal Vein Occlusion: Classification and Treatment

Parodi

Bandello²

2009

Ophthalmologica

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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. The limited functional outcomes achievable by means of laser treatment have prompted researchers to try alternative options, with varying results. The recent introduction of combined therapies for macular edema may provide a superior approach in an attempt to improve and stabilize visual acuity over a long-term follow-up.

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Management of branch retinal vein occlusion with vitrectomy and arteriovenous adventitial sheathotomy, the possible role of surgical posterior vitreous detachment

Cited by 68 publications

References 21 publications

Intravitreal Functional Plasminogen Is Elevated in Central Retinal Vein Occlusion

Intravitreal Functional Plasminogen Is Elevated in Central Retinal Vein Occlusion

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

Branch Retinal Vein Occlusion: Classification and Treatment

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