Tractional retinal detachment after branch retinal vein occlusion. Influence of disc neovascularization on the outcome of vitreous surgery.

OBJECTIVE

This study aimed to investigate the influence of disc neovascularization on the outcome of vitreous surgery for tractional retinal detachment (TRD) after branch retinal vein occlusion (BRVO).

DESIGN

The study design was a retrospective case series.

PARTICIPANTS

Twenty-two eyes of 22 patients who had undergone vitrectomy for TRD after BRVO at the Osaka National Hospital (Osaka, Japan) or the Surugadai Hospital of Nihon University (Tokyo, Japan) between 1985 and 1995 participated. Seven (32%) of 22 eyes had a TRD secondary to neovascularization of the optic disc (NVD) and neovascularization elsewhere (NVE; group I), and 15 (68%) had a TRD with NVE without NVD (group II).

MAIN OUTCOME MEASURES

Visual acuities and retinal reattachment rates were measured.

RESULTS

Sixteen (73%) of the 22 study eyes showed severe vitreous hemorrhage before surgery, and 11 eyes (50%) had received laser photocoagulation treatment before surgery. Fourteen (64%) of the study eyes achieved total retinal reattachment after initial vitrectomy, and 19 eyes (86%) were reattached completely at final examination. Thirteen eyes (59%) achieved a visual acuity of better than 0.1. Group I patients had a significantly higher rate of recurrent combined traction rhegmatogenous retinal detachment (P = 0.01) and a significantly worse final visual outcome (P = 0.01).

CONCLUSIONS

Better surgical results are expected in eyes without NVD than with NVD among patients who undergo vitrectomy for TRD after BRVO. Although the authors were unable to determine the reason for this difference in the current study, they speculate that the degree of retinal nonperfusion, diffusible angiogenic factors, and distance of the site of occlusion from the disc may each affect visual and anatomic outcomes in these eyes.