PURPOSE: This study was designed to evaluate the effect of vitrectomy on the recovery of impaired visual acuity from complication of branch retinal vein occlusion (BRVO). METHODS: The medical records were obtained from all patients who underwent vitreoretinal surgery for complication of BRVO and were followed up at least for 6 months postoperatively. RESULTS: The Surgical indications included vitreous hemorrhage (29 patients), epiretinal membrane (7), and retinal detachment (4). Mean follow-up was 13 months. Preoperatively, best corrected visual acuity was greater than or equal to 0.1 in 14 eyes (35.0%). Six months postoperatively, best corrected visual acuity was greater than or equal to 0.1 in 36 eyes (90.0%). Clinical features associated with better visual outcome included better preoperative visual acuity (P<0.01) and absence of preoperative macular edema (P<0.02). CONCLUSIONS: Vitrectomy is a good procedure for the recovery on the visual impairment due to BRVO complication.
Epiretinal Membrane ; Follow-Up Studies ; Humans ; Macular Edema ; Medical Records ; Retinal Detachment ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Vision Disorders ; Visual Acuity ; Vitrectomy* ; Vitreoretinal Surgery ; Vitreous Hemorrhage

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. Mean BCVA (logMAR) in the surgery group changed from 1.10+/-0.34 to 1.19+/-0.70 and to 0.80+/-0.36 at 12 and 36 months, respectively (p=0.959 at 12 months, p=0.018 at 36 months). In the control group, visual acuity improved from 1.15+/-0.43 to 0.43+/-0.44 and to 0.43+/-0.39 at 12 and 36 months, respectively (p=0.015 at 12 months, at p=0.003 at 36 months). A strong trend toward better visual acuity at 12 months and final examination was observed for controls. (surgery vs. control group, p=0.052 at 12 months, p=0.066 at 36 months). CONCLUSIONS: Considering the favorable natural course of BVO and the unproven effect of reperfusion on macular edema, surgical efficacy of arteriovenous adventitial sheathotomy requires further evaluation.
Aged ; Connective Tissue/*surgery ; Decompression, Surgical/methods ; Female ; Humans ; Macular Edema/etiology/physiopathology/*surgery ; Male ; Middle Aged ; Retinal Artery ; Retinal Vein ; Retinal Vein Occlusion/complications/physiopathology/*surgery ; Retrospective Studies ; Treatment Outcome ; Visual Acuity/*physiology ; Vitrectomy/*methods

Diabetic Retinopathy ; complications ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Retinal Vein Occlusion ; complications ; Vitrectomy ; Vitreous Hemorrhage ; etiology ; surgery

No abstract available.
Humans ; Laser Therapy/methods ; Magnetic Resonance Imaging ; Male ; Orbital Cellulitis/*complications/diagnosis ; Retinal Vein Occlusion/diagnosis/*etiology/surgery ; Tomography, X-Ray Computed ; Young Adult

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 > or =2 lines was observed in 10 eyes (45%). The mean preoperative fovea thickness measured by OCT was 595.22+/-76.83 micrometer (510-737 micrometer) and postoperative fovea thickness was 217.60+/-47.33 micrometer (164-285 micrometer). CONCLUSIONS: Vitrectomy with AV sheathotomy can be one treatment option for the patients with recurrent macular edema in BRVO.
Treatment Outcome ; Tomography, Optical Coherence ; Retrospective Studies ; Retinal Vein Occlusion/*complications/diagnosis/surgery ; Ophthalmologic Surgical Procedures/*methods ; Middle Aged ; Male ; Macular Edema, Cystoid/diagnosis/etiology/*surgery ; Macula Lutea/*surgery ; Humans ; Fundus Oculi ; Follow-Up Studies ; Fluorescein Angiography ; Female

PURPOSE: There is currently no treatment proven effective for central retinal vein occlusion (CRVO). Radial optic neurotomy (RON) has recently surfaced as a new treatment for the disorder, however, and we compare here the visual acuity (VA) and arteriovenous transit time (AVTT) following RON and panretinal photocoagulation (PRP). METHODS: We conducted a retrospective, uncontrolled study of 27 patients. Of 27 eyes diagnosed with CRVO, 16 were treated with panretinal photocoagulation (PRP) and 11 with RON. VA and fluorescein angiography were used to monitor the evolution of CRVO, and for follow-up. RESULTS: All patients underwent PRP or RON with no major complications. The difference between pre- and post-operative VA was not statistically significant for either group (p=0.092 on PRP; p=.0081 on RON). The change in AVTT was also not statistically significant for either group (p=0.024 on PRP; p=0.027 on RON). Ultimately, we found no statistically-significant difference in comparing VA and AVTT for the two groups (p=0.074 on VA; p=0.510 on AVTT). CONCLUSIONS: No evidence supporting the effectiveness of RON could be found in this study, suggesting that surgical decompression by RON may not be effective for treating CRVO. Further studies regarding the efficacy of RON should be made.
Visual Acuity ; Treatment Outcome ; Retrospective Studies ; Retinal Vein Occlusion/pathology/physiopathology/*surgery ; Retina/*surgery ; Optic Nerve/*surgery ; Middle Aged ; Male ; Laser Coagulation/*methods ; Humans ; Follow-Up Studies ; Female ; Decompression, Surgical/*methods ; Aged ; Adult

INTRODUCTIONMacular oedema is the main cause of visual impairment following retinal vein occlusion. The purpose of this study was to evaluate the anatomical and functional outcome of pars plana vitrectomy and internal limited membrane (ILM) peeling for macular oedema secondary to retinal vein occlusion.

CLINICAL PICTUREThis pilot study is a prospective nonrandomised series of 11 eyes of 11 patients with macular oedema secondary to retinal vein occlusion. The best-corrected visual acuity (BCVA), foveal thickness on optical coherence tomography, fundus fluorescein angiography (FFA) and multifocal electroretinography were evaluated.

TREATMENT AND OUTCOMEAll 11 patients underwent pars plana vitrectomy with ILM peeling. The mean postoperative follow-up was 13.5 months (range, 1.5 to 24). The mean thickness at the foveal centre decreased from 794 +/- 276 microm preoperatively to 373 +/- 150 microm, 302 +/- 119 microm, 249 +/- 203 microm and 185 +/- 66 microm at 1 week, 1 month, 3 months and the final visit postoperatively, respectively (all P <0.001, paired t- test, compared to preoperative thickness). Postoperative FFA demonstrated markedly reduced leakage in the macular region. At the final visit, BCVA improved 2 lines or more in 72.7% (8/11) of patients and was unchanged in 27.3% (3/11) patients. Complications included cataract in 7 patients and vitreous haemorrhage, recurrence of macular oedema and visual field defect in 1 case each.

CONCLUSIONPars plana vitrectomy and ILM peeling rapidly reduced the macular oedema caused by retinal vein occlusion, with improvement in BCVA.

Adult ; Aged ; Epiretinal Membrane ; pathology ; surgery ; Female ; Humans ; Macular Edema ; etiology ; surgery ; Male ; Middle Aged ; Pars Planitis ; pathology ; surgery ; Pilot Projects ; Prospective Studies ; Retinal Vein Occlusion ; complications ; Visual Acuity ; Vitrectomy

OBJECTIVE: To investigate the outcomes of percutaneous unilateral metallic stent placement in patients with a malignant obstruction of the biliary hila and a contralateral portal vein steno-occlusion. MATERIALS AND METHODS: Sixty patients with a malignant hilar obstruction and unilobar portal vein steno-occlusion caused by tumor invasion or preoperative portal vein embolization were enrolled in this retrospective study from October 2010 to October 2013. All patients were treated with percutaneous placement of a biliary metallic stent, including expanded polytetrafluoroethylene (ePTFE)-covered stents in 27 patients and uncovered stents in 33 patients. RESULTS: A total of 70 stents were successfully placed in 60 patients. Procedural-related minor complications, including self-limiting hemobilia (n = 2) and cholangitis (n = 4) occurred in six (10%) patients. Acute cholecystitis occurred in two patients. Successful internal drainage was achieved in 54 (90%) of the 60 patients. According to a Kaplan-Meier analysis, median survival time was 210 days (95% confidence interval [CI], 135-284 days), and median stent patency time was 133 days (95% CI, 94-171 days). No significant difference in stent patency was observed between covered and uncovered stents (p = 0.646). Stent dysfunction occurred in 16 (29.6%) of 54 patients after a mean of 159 days (range, 65-321 days). CONCLUSION: Unilateral placement of ePTFE-covered and uncovered stents in the hepatic lobe with a patent portal vein is a safe and effective method for palliative treatment of patients with a contralateral portal vein steno-occlusion caused by an advanced hilar malignancy or portal vein embolization. No significant difference in stent patency was detected between covered and uncovered metallic stents.
Adult ; Aged ; Aged, 80 and over ; Biliary Tract Neoplasms/surgery ; Cholangitis/etiology ; Cholestasis/*surgery ; Female ; Hemobilia/etiology ; Humans ; Kaplan-Meier Estimate ; Liver/blood supply/pathology/surgery ; Liver Neoplasms/surgery ; Male ; Middle Aged ; Palliative Care/methods ; Polytetrafluoroethylene ; Portal Vein/pathology/*surgery ; Retinal Vein Occlusion/*surgery ; Retrospective Studies ; Stents/*adverse effects ; Treatment Outcome

A 58-year-old man admitted to our opthalmology department with the complaint of branch retinal vein occlusion. He was treated with intravitreal Ozurdex in the right eye. Two days after the injection, the patient presented with ocular pain and the visual acuity was hand movement. A diagnosis of endophthalmitis was made. We performed emergent pars plana vitrectomy (PPV) and the implant was removed from the vitreous cavity using a retinal forceps. A combination of vancomycin 1.0 mg and amikacin 0.4 mg was injected intravitreally. However, because of the blurring in the vitreus one week after the procedure, phacoemulsification and a repeat PPV was performed. Five days after the last procedure the signs and symptoms of endophthalmitis were resolved. Our case demonstrated that endophthalmitis could develop after intravitreal implantation of Ozurdex. Surgical removal of the implant and immediate vitrectomy seems to be a useful treatment option in these cases.
Device Removal/methods ; Dexamethasone/administration & dosage/*adverse effects ; Diagnosis, Differential ; Drug Implants/*adverse effects ; Endophthalmitis/diagnosis/*etiology/surgery ; Eye Infections, Bacterial/diagnosis/*etiology/surgery ; Glucocorticoids/administration & dosage/adverse effects ; Humans ; Intravitreal Injections/adverse effects ; Male ; Middle Aged ; Retinal Vein Occlusion/diagnosis/*drug therapy ; Vitrectomy