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Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 4/2005

01-04-2005 | Clinical Investigation

Angiographic findings in arteriovenous dissection (sheathotomy) for decompression of branch retinal vein occlusion

Authors: Thomas Kube, Nicolas Feltgen, Mona Pache, Julia Herrmann, Lutz Lothar Hansen

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 4/2005

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Abstract

Background

Arteriovenous dissection (sheathotomy) is a new therapeutic option in patients with branch retinal vein occlusion (BRVO) and macular involvement. We present an angiographic follow-up of 22 patients who underwent arteriovenous dissection (AVD).

Methods

Twenty-two patients (15 women; mean age 68.7±8.0 years) were examined preoperatively and 6 weeks, 3 months, 6 months, and 1 year after AVD. For assessment of retinal hemodynamics, arteriovenous passage time (AVP) of the affected and unaffected branches at first (AVPe) and at maximal (AVPmax) venous filling were measured. Changes in the foveal avascular zone (FAZ) were calculated to determine foveal structural changes. Visual acuity was assessed as functional parameter.

Results

The early AVP (AVPe) of the affected branch increased from 4.4±0.8 s preoperatively to 4.9±0.6 s 6 weeks after surgery and decreased to 2.7±0.4 s 1 year after surgery (p=0.05). When compared to the unaffected control branch, AVPe was significantly increased in the affected branch preoperatively (4.5±0.8 s versus 1.5±0.2 s, p<0.01), 6 weeks (4.9±0.6 s versus 2.1±0.3 s, p<0.01), 3 months (2.7±0.4 s versus 1.5±0.2 s, p<0.01), and 6 months (3.1±0.4 s versus 2.2±0.3 s, p=0.02) after AVD. After 1 year, AVPe no longer differed between the affected and the control branch (2.7±0.4 s versus 2.6± 0.3 s). AVPmax was significantly increased in the affected branch preoperatively (11.8±0.8 s versus 7.7±1.0 s, p<0.05). The AVPmax in the affected branch with the exception of 3 months after surgery (10.2±1.1 s, p<0.01) was no longer elevated when compared to preoperative values. The area of the FAZ did not change significantly but showed a trend for enlargement.

Conclusion

AVD for decompression of BRVO leads to a significant decrease of AVP and may ameliorate retinal perfusion in the affected branch.
Literature
1.
go back to reference Arend O, Wolf S, Remky A, Sponsel WE, Harris A, Bertram B, Reim M (1994) Perifoveal microcirculation with non-insulin-dependent diabetes mellitus. Graefes Arch Clin Exp Ophthalmol 232(4):225–231PubMed Arend O, Wolf S, Remky A, Sponsel WE, Harris A, Bertram B, Reim M (1994) Perifoveal microcirculation with non-insulin-dependent diabetes mellitus. Graefes Arch Clin Exp Ophthalmol 232(4):225–231PubMed
2.
go back to reference Cahill MT, Fekrat S (2002) Arteriovenous sheathotomy for branch retinal vein occlusion. Ophthalmol Clin North Am 15(4):417–423PubMed Cahill MT, Fekrat S (2002) Arteriovenous sheathotomy for branch retinal vein occlusion. Ophthalmol Clin North Am 15(4):417–423PubMed
3.
go back to reference Charbonnel J, Glacet-Bernard A, Korobelnik JF, Nyouma-Moune E, Pournaras CJ, Colin J, Coscas G, Soubrane G (2004) Management of branch retinal vein occlusion with vitrectomy and arteriovenous adventitial sheathotomy, the possible role of surgical posterior vitreous detachment. Graefes Arch Clin Exp Ophthalmol 242(3):223–228CrossRefPubMed Charbonnel J, Glacet-Bernard A, Korobelnik JF, Nyouma-Moune E, Pournaras CJ, Colin J, Coscas G, Soubrane G (2004) Management of branch retinal vein occlusion with vitrectomy and arteriovenous adventitial sheathotomy, the possible role of surgical posterior vitreous detachment. Graefes Arch Clin Exp Ophthalmol 242(3):223–228CrossRefPubMed
4.
go back to reference Chen HC, Wiek J, Gupta A, Luckie A, Kohner EM (1998) Effect of isovolaemic haemodilution on visual outcome in branch retinal vein occlusion. Br J Ophthalmol 82(2):162–167PubMed Chen HC, Wiek J, Gupta A, Luckie A, Kohner EM (1998) Effect of isovolaemic haemodilution on visual outcome in branch retinal vein occlusion. Br J Ophthalmol 82(2):162–167PubMed
5.
go back to reference Dotrelova D, Dubska Z, Kuthan P, Stepankova J (2001) Initial experience with surgical decompression of the vein in branch retinal vein occlusion [Czech]. Ceska a Slovenska Oftalmologie 57(6):359–366PubMed Dotrelova D, Dubska Z, Kuthan P, Stepankova J (2001) Initial experience with surgical decompression of the vein in branch retinal vein occlusion [Czech]. Ceska a Slovenska Oftalmologie 57(6):359–366PubMed
6.
go back to reference Duker JS, Brown GC (1989) Anterior location of the crossing artery in branch retinal vein occlusion. Arch Ophthalmol 107:998–1000PubMed Duker JS, Brown GC (1989) Anterior location of the crossing artery in branch retinal vein occlusion. Arch Ophthalmol 107:998–1000PubMed
7.
go back to reference Figueroa MS, Torres R, Alvarez MT (2004) Comparative study of vitrectomy with and without vein decompression for branch retinal vein occlusion: a pilot study. Eur J Ophthalmol 14(1):40–47PubMed Figueroa MS, Torres R, Alvarez MT (2004) Comparative study of vitrectomy with and without vein decompression for branch retinal vein occlusion: a pilot study. Eur J Ophthalmol 14(1):40–47PubMed
8.
go back to reference Frangieh GT, Green R, Barraquer-Somers E, Finkelstein D (1982) Histopathologic study of nine branch retinal vein occlusions. Arch Ophthalmol 100:1132–1140PubMed Frangieh GT, Green R, Barraquer-Somers E, Finkelstein D (1982) Histopathologic study of nine branch retinal vein occlusions. Arch Ophthalmol 100:1132–1140PubMed
9.
go back to reference Fujii GY, de Juan E Jr, Humayun MS (2003) Improvements after sheathotomy for branch retinal vein occlusion documented by optical coherence tomography and scanning laser ophthalmoscope. Ophthalmic Surg Lasers Imaging 34(1):49–52PubMed Fujii GY, de Juan E Jr, Humayun MS (2003) Improvements after sheathotomy for branch retinal vein occlusion documented by optical coherence tomography and scanning laser ophthalmoscope. Ophthalmic Surg Lasers Imaging 34(1):49–52PubMed
10.
go back to reference Fujio N, Feke GT, Ogasawara H, Goger DG, Yoshida A, McMeel JW (1994) Quantitative circularory measurements in branch retinal vessel occlusion. Eye 8:324–328PubMed Fujio N, Feke GT, Ogasawara H, Goger DG, Yoshida A, McMeel JW (1994) Quantitative circularory measurements in branch retinal vessel occlusion. Eye 8:324–328PubMed
11.
go back to reference Gabel VP, Birngruber R, Nasemann J (1988) Fluorescein angiography with the scanning laser ophthalmoscope (SLO). Lasers Light Ophthalmol 2(1):35–40 Gabel VP, Birngruber R, Nasemann J (1988) Fluorescein angiography with the scanning laser ophthalmoscope (SLO). Lasers Light Ophthalmol 2(1):35–40
12.
go back to reference Green WR, Chan CC, Hutchins GM, Terry JM (1981) Central retinal vein occlusion: a prospective histopathologic study of 29 eyes in 28 cases. Trans Am Ophthalmol Soc 79:371–421PubMed Green WR, Chan CC, Hutchins GM, Terry JM (1981) Central retinal vein occlusion: a prospective histopathologic study of 29 eyes in 28 cases. Trans Am Ophthalmol Soc 79:371–421PubMed
13.
go back to reference Hansen LL, Danisevskis P, Arntz HR, Hövener G, Wiederholt MA (1985) Randomised prospective study on treatment of central retinal vein occlusion by isovolaemic haemodilution and photocoagulation. Br J Ophthalmol 69:108–116PubMed Hansen LL, Danisevskis P, Arntz HR, Hövener G, Wiederholt MA (1985) Randomised prospective study on treatment of central retinal vein occlusion by isovolaemic haemodilution and photocoagulation. Br J Ophthalmol 69:108–116PubMed
14.
go back to reference Hansen LL, Wiek J, Arntz R (1988) Randomisierte Studie zur Wirkung der isovolämischen Hämodilution bei retinalen Venenastverschlüssen. Fortschr Ophthalmol 85:514–516PubMed Hansen LL, Wiek J, Arntz R (1988) Randomisierte Studie zur Wirkung der isovolämischen Hämodilution bei retinalen Venenastverschlüssen. Fortschr Ophthalmol 85:514–516PubMed
15.
go back to reference Hayreh SS (1994) Retinal vein occlusion. Indian J Ophthalmol 42(3):109–132PubMed Hayreh SS (1994) Retinal vein occlusion. Indian J Ophthalmol 42(3):109–132PubMed
16.
go back to reference Kang G, Lee J (1995) Retinal circulation times in branch retinal vein occlusion. Korean J Ophthalmol 9(2):107–110PubMed Kang G, Lee J (1995) Retinal circulation times in branch retinal vein occlusion. Korean J Ophthalmol 9(2):107–110PubMed
17.
go back to reference Kumar B, Yu DY, Morgan WH, Barry CJ, Constable IJ, McAllister IL (1998) The distribution of angioarchitectural changes within the vicinity of the arteriovenous crossing in branch retinal vein occlusion. Ophthalmology 105(3):424–427CrossRefPubMed Kumar B, Yu DY, Morgan WH, Barry CJ, Constable IJ, McAllister IL (1998) The distribution of angioarchitectural changes within the vicinity of the arteriovenous crossing in branch retinal vein occlusion. Ophthalmology 105(3):424–427CrossRefPubMed
18.
go back to reference Le Rouic JF, Bejjani RA, Rumen F, Caudron C, Bettembourg O, Renard G, Chauvaud D (2001) Adventitial sheathotomy for decompression of recent onset branch retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 239(10):747–751PubMed Le Rouic JF, Bejjani RA, Rumen F, Caudron C, Bettembourg O, Renard G, Chauvaud D (2001) Adventitial sheathotomy for decompression of recent onset branch retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 239(10):747–751PubMed
19.
go back to reference Lu L, Li Y, Yi C, Li M, Lu X, Zhang J (2003) Preliminary clinical observation of arteriovenous sheathotomy for treatment of branch retinal vein occlusion. Yan Ke Xue Bao 19(1):33–38PubMed Lu L, Li Y, Yi C, Li M, Lu X, Zhang J (2003) Preliminary clinical observation of arteriovenous sheathotomy for treatment of branch retinal vein occlusion. Yan Ke Xue Bao 19(1):33–38PubMed
20.
go back to reference Mason J, Swanner J, Feist RM, White M, McGwin G Jr, Emond T (2002) Arteriovenous sheathotomy to surgically decompress branch retinal vein occlusion: a matched control study, in ARVO. Edited by IOVS. Fort Lauderdale Mason J, Swanner J, Feist RM, White M, McGwin G Jr, Emond T (2002) Arteriovenous sheathotomy to surgically decompress branch retinal vein occlusion: a matched control study, in ARVO. Edited by IOVS. Fort Lauderdale
21.
go back to reference Mester U, Dillinger P (2002) Vitrectomy with arteriovenous decompression and internal limiting membrane dissection in branch retinal vein occlusion. Retina 22(6):740–746CrossRefPubMed Mester U, Dillinger P (2002) Vitrectomy with arteriovenous decompression and internal limiting membrane dissection in branch retinal vein occlusion. Retina 22(6):740–746CrossRefPubMed
22.
go back to reference Myers J, Akduman L (2002) Sheathotomy for branch retinal vein occlusion, in ARVO. Edited by IOVS. Fort Lauderdale Myers J, Akduman L (2002) Sheathotomy for branch retinal vein occlusion, in ARVO. Edited by IOVS. Fort Lauderdale
23.
go back to reference Opremcak EM, Bruce RA (1999) Surgical decompression of branch retinal vein occlusion via arteriovenous crossing sheathotomy: a prospective review of 15 cases. Retina 19(1):1–5PubMed Opremcak EM, Bruce RA (1999) Surgical decompression of branch retinal vein occlusion via arteriovenous crossing sheathotomy: a prospective review of 15 cases. Retina 19(1):1–5PubMed
24.
go back to reference Saika S, Tanaka T, Miyamoto T, Ohnishi Y (2001) Surgical posterior vitreous detachment combined with gas/air tamponade for treating macular edema associated with branch retinal vein occlusion: retinal tomography and visual outcome. Graefes Arch Clin Exp Ophthalmol 239(10):729–732PubMed Saika S, Tanaka T, Miyamoto T, Ohnishi Y (2001) Surgical posterior vitreous detachment combined with gas/air tamponade for treating macular edema associated with branch retinal vein occlusion: retinal tomography and visual outcome. Graefes Arch Clin Exp Ophthalmol 239(10):729–732PubMed
25.
go back to reference Shah GK (2000) Adventitial sheathotomy for treatment of macular edema associated with branch retinal vein occlusion. Curr Opin Ophthalmol 11(3):171–174CrossRefPubMed Shah GK (2000) Adventitial sheathotomy for treatment of macular edema associated with branch retinal vein occlusion. Curr Opin Ophthalmol 11(3):171–174CrossRefPubMed
26.
go back to reference Shah GK, Sharma S, Fineman MS, Federman J, Brown MM, Brown GC (2000) Arteriovenous adventitial sheathotomy for the treatment of macular edema associated with branch retinal vein occlusion. Am J Ophthalmol 129(1):104–106CrossRefPubMed Shah GK, Sharma S, Fineman MS, Federman J, Brown MM, Brown GC (2000) Arteriovenous adventitial sheathotomy for the treatment of macular edema associated with branch retinal vein occlusion. Am J Ophthalmol 129(1):104–106CrossRefPubMed
27.
go back to reference Staurenghi G, Lonati C, Aschero M, Orzalesi N (1994) Arteriovenous crossing as a risk factor in branch retinal vein occlusion. Am J Ophthalmol 117:211–213PubMed Staurenghi G, Lonati C, Aschero M, Orzalesi N (1994) Arteriovenous crossing as a risk factor in branch retinal vein occlusion. Am J Ophthalmol 117:211–213PubMed
28.
go back to reference Wolf S, Bertram B, Reim M (1987) Measurement of retinal blood flow parameters in central retinal vein occlusion (CRVO). Elsevier, Amsterdam Wolf S, Bertram B, Reim M (1987) Measurement of retinal blood flow parameters in central retinal vein occlusion (CRVO). Elsevier, Amsterdam
29.
go back to reference Wolf S, Arend O, Bertram B, Schulte K, Teping C, Reim M (1989) Hemodilution therapy in central retinal vein occlusion: a randomized placebo controlled study. Clin Hemorheology 9(6) Wolf S, Arend O, Bertram B, Schulte K, Teping C, Reim M (1989) Hemodilution therapy in central retinal vein occlusion: a randomized placebo controlled study. Clin Hemorheology 9(6)
30.
go back to reference Wolf S, Toonen H, Koyama T, Meyer-Ebrecht D, Reim M (1990) Scanning laser ophthalmoscopy for the quantification of retinal blood-flow parameters: a new imaging technique. Quintessenz, München Wolf S, Toonen H, Koyama T, Meyer-Ebrecht D, Reim M (1990) Scanning laser ophthalmoscopy for the quantification of retinal blood-flow parameters: a new imaging technique. Quintessenz, München
31.
go back to reference Yamaji H, Shiraga F, Tsuchida Y, Yamamoto Y, Ohtsuki H (2004) Evaluation of arteriovenous crossing sheathotomy for branch retinal vein occlusion by fluorescein videoangiography and image analysis. Am J Ophthalmol 137(5):834–841CrossRefPubMed Yamaji H, Shiraga F, Tsuchida Y, Yamamoto Y, Ohtsuki H (2004) Evaluation of arteriovenous crossing sheathotomy for branch retinal vein occlusion by fluorescein videoangiography and image analysis. Am J Ophthalmol 137(5):834–841CrossRefPubMed
Metadata
Title
Angiographic findings in arteriovenous dissection (sheathotomy) for decompression of branch retinal vein occlusion
Authors
Thomas Kube
Nicolas Feltgen
Mona Pache
Julia Herrmann
Lutz Lothar Hansen
Publication date
01-04-2005
Publisher
Springer-Verlag
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 4/2005
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-004-0983-y

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