Macular Vein Occlusion Research Articles

Possible effects of internal limiting membrane peeling in vitrectomy for macular vein occlusion

To evaluate the effect of pars plana vitrectomy (PPV) either with or without internal limiting membrane (ILM) peeling for macular edema associated with macular vein occlusion (MVO). In this retrospective, interventional, comparative case series study, 41 patients (41 eyes) underwent PPV either with or without ILM peeling for macular edema due to MVO. Twenty-eight eyes without ILM peeling (PPV alone) were compared with 13 eyes with ILM peeling (ILM-off). The main outcome measures were best-corrected visual acuity (BCVA) and foveal thickness, evaluated by optical coherence tomography. Baseline demographic characteristics of the two groups were similar. Postoperative follow-up period ranged from 12 to 53 months (mean, 27.9 months). The postoperative mean BCVA improved and foveal thickness decreased significantly in both groups. The difference in BCVA between the two groups was not significant at any time point. The mean foveal thickness in the ILM-off group was thicker than that in the PPV alone group during the follow-up period. No patient had severe intraoperative or postoperative complications. PPV either with or without ILM peeling may improve the anatomical and functional outcomes of macular edema secondary to MVO. Removal of the ILM does not appear to affect visual outcome; however, it may not reduce the foveal thickness as much as PPV alone.

Effect of laser photocoagulation on the retinal vessel diameter in branch and macular vein occlusion.

To investigate the response of retinal vessel diameters to photocoagulation treatment and their role for the success of laser treatment in patients with retinal vein occlusion. The study included 14 patients with branch vein occlusion or macular vein occlusion. The ophthalmologic examination included best-corrected visual acuity, biomicroscopy, fundus photography, and fluorescein angiography. Retinal vessel diameters were quantified before and after laser photocoagulation using a retinal vessel analyzer. Retinal vessel diameters. In cases manifesting macular vein occlusions, no significant change of the vessel diameter in any vessel was observed during the follow-up period. In the group with branch vein occlusion, all vessels tended to constrict after the laser photocoagulation. The effect of laser treatment on retinal vessel diameters was significant for superotemporal (P =.045, analysis of variance [ANOVA]) and inferotemporal branch veins (P =.03, ANOVA). Vasoconstriction was more pronounced in the occluded branch veins (P =.009, ANOVA) compared with the nonaffected veins (P =.12; ANOVA). The change of visual acuity after 3 months was correlated with the change of vessel diameter 3 months after laser treatment for occluded venular branches (r = 0.78, P =.02, linear regression). There was no correlation between the number of laser burns and the change of vessel diameters in the affected veins in this period (r = 0.12, P =.75, linear regression). Our results show that retinal photocoagulation in patients with branch vein occlusion has a vasoconstrictive effect on occluded veins. The correlation between the change in visual acuity and the change in vessel diameter indicates that branch vein constriction after photocoagulation may be an early indicator of the success of laser treatment.

Macular Branch Vein Occlusion

Occlusion of a small macular tributary branch vein, not involving a major arcade, can be extremely subtle and the correct diagnosis is frequently missed. Capable of adversely affecting central visual acuity, macular vein occlusion has a variable clinical presentation and course which may elude more conventional examination techniques and require fluorescein angiography to confirm or establish its presence. Recognizing the need for increased awareness of this disorder, emphasis is placed on orientation through case presentations depicting the clinical and angiographic features of this subgroup of branch retinal vein occlusions. A retrospective evaluation of the cl inical data and angiographic features of 75 individuals with macular branch vein occlusion permitted evaluation of 64 patients with follow-up ranging from two months to ten years. Various forms of medical therapy were used in the management of many of these individuals, but argon laser photocoagulation was only used in 22 patients. The limitations inherent in interpreting data from uncontrolled studies are acknowledged. Our observations support the need for recognition and intensive evaluation of this special group of vein occlusions.