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Five-year outcomes of pars plana vitrectomy for macular edema associated with branch retinal vein occlusion

Authors Nishida A, Kojima H, Kameda T, Mandai M, Kurimoto Y

Received 28 September 2016

Accepted for publication 23 December 2016

Published 17 February 2017 Volume 2017:11 Pages 369—375

DOI https://doi.org/10.2147/OPTH.S123419

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Jie Zhang

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Akihiro Nishida,1,2 Hiroshi Kojima,1,2 Takanori Kameda,1,2 Michiko Mandai,1,3 Yasuo Kurimoto1,2

1Department of Ophthalmology, Kobe City Medical Center General Hospital, 2Department of Ophthalmology, Institute of Biomedical Research and Innovation, 3Laboratory for Retinal Regeneration, RIKEN Center for Developmental Biology, Chuo-ku, Kobe, Hyogo, Japan

Purpose: Long-term outcomes of pars plana vitrectomy (PPV) for macular edema (ME) associated with branch retinal vein occlusion (BRVO) have been previously reported, but the studies did not report the number of additional treatments after surgery. During 5 years of follow-up, we therefore investigated the efficacy and safety of PPV for BRVO and evaluated the incidence of additional treatments.
Methods: We retrospectively reviewed the medical records of 25 eyes of 24 patients who underwent PPV for ME associated with BRVO and were followed up for at least 5 years. Best-corrected visual acuity was measured, and foveal thickness was assessed by optical coherence tomography. Additional treatments were also investigated.
Results: The logarithm of the minimal angle of resolution (logMAR) improved from 0.53±0.23 at baseline to 0.16±0.25 at 5 years (P<0.0001). The foveal thickness decreased from 535±222 µm at baseline to 205±143 µm at 5 years (P<0.0001). For the eyes with residual ME, the following additional treatments were performed within 5 years of follow-up: sub-Tenon injection of triamcinolone acetonide in two eyes, intravitreal injection of bevacizumab in three eyes, grid laser photocoagulation in one eye, and direct photocoagulation of macroaneurysm in one eye. Additional surgeries were performed in two eyes: for one eye, phacoemulsification extraction of the ocular lens and intraocular lens implantation were performed because of cataract progression, and for the other eye, additional PPV was done for postoperative retinal detachment.
Conclusion: PPV was effective for resolution of ME associated with BRVO and improved visual acuity with a small number of additional treatments during long-term follow-up.

Keywords: branch retinal vein occlusion, macular edema, pars plana vitrectomy, 5-year outcomes

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