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Arteriovenous adventitial sheathotomy for branch retinal vein occlusion: report of a case with longterm follow-up.

PURPOSE
To report the longterm follow-up of a case of branch retinal vein occlusion (BRVO) treated with vitrectomy and adventitial sheathotomy.


METHODS
A three-port vitrectomy was performed in a 55-year-old man with symptoms of BRVO of about 3 months' duration. After a core vitrectomy, the adventitial sheath of the affected arteriovenous crossing was dissected so that the anterior surface of the arteriole was freely exposed.


RESULTS
On the second postoperative day, visual acuity (VA) in the affected left eye had increased from preoperative 0.3 to 0.6. Within 6 months the fundus had almost normalized and vision improved to 1.0. Cataract surgery was performed about 2 years after the vitrectomy. At a follow-up 4 years and 11 months after the sheathotomy, VA was 1.0 and no signs of recurrence were seen.


CONCLUSIONS
Adventitial sheathotomy may improve vision in selected cases of BRVO. Further studies are necessary to determine the role of sheathotomy in the management of cases with BRVO.