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Long-term visual outcomes after vitrectomy for macular edema with foveal hemorrhage in branch retinal vein occlusion.

Kumagai K, Furukawa M, Ogino N, Larson E, Uemura A

Shinjo Ophthalmologic Institute, 889 Mego, Shimoki-takata-cho, Miyazaki 880-0035, Japan. kumagai3@f8.dion.ne.jp

PURPOSE: To determine the long-term visual outcomes after vitreous surgery for macular edema with foveal hemorrhage associated with branch retinal vein occlusion (BRVO). METHODS: One hundred twenty eyes of 120 patients underwent pars plana vitrectomy with or without internal limiting membrane (ILM) peeling for macular edema with foveal hemorrhage due to BRVO with a minimum 12 months of follow-up. Simultaneous cataract extraction with intraocular lens implantation was performed on 117 phakic eyes. RESULTS: Follow-up after surgery ranged from 12 months to 129 months (average, 48 months). Visual acuity improved in 71% of cases at the 1-year visit. Mean visual acuity significantly increased from 0.24 (median, 0.3) before surgery to 0.57 (median, 0.7) 1 year after surgery (P < 0.0001) and 0.66 (median, 0.9) at the final visit (P < 0.0001). There was a significant difference between visual acuity at 1 year after surgery and visual acuity at the final visit (P < 0.0001). Of 120 patients, 95 (79%) had final visual acuity of > or =0.5, and 55 (46%) had final visual acuity of > or =1.0. ILM removal did not seem to have significant beneficial effects on visual outcomes in this series. No serious complications occurred during the follow-up period. CONCLUSION: After vitreous surgery for macular edema with foveal hemorrhage associated with BRVO, visual acuity continued to improve beyond 1 year after surgery. A randomized, multicenter clinical trial is warranted to determine the efficacy of this procedure.

Published 11 June 2007 in Retina, 27(5): 584-8.
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