M M Much1, L Hesse. 1. Augenklinik und Poliklinik, Universitätsklinikum Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Deutschland, much_m@klinik.uni-wuerzburg.de.
Abstract
BACKGROUND: There is currently no effective therapy for retinal artery branch occlusion (RABO). Transluminal Nd:YAG embolectomy (TYE) was developed to achieve rapid reperfusion; however, it is still a subject of controversy. A Nd:YAG laser is focused on the occluded vessel, the vessel wall is ruptured and the embolism dislocates to the vitreous humor through the opening in the artery. METHOD: We retrospectively examined the results of five patients treated with TYE. RESULTS: The age of the patients was 26-75 years (mean age 58 years, median 68 years). Initial visual acuity was hand movements to 1.0 and all patients had visual field defects. Treatment was performed between 4 and 30 h from the onset of symptoms. Visual acuity improved markedly in two cases the next day (hand movements to 0.8 and 0.4 to 1.0) and final visual acuity was between 0.8 and 1.25. All treatments led to vitreous hemorrhage but only one patient required surgical treatment. The range of follow-up was 4-42 months. CONCLUSIONS: The results are in accordance with those published in the literature. It can be concluded that TYE is a fast, easy and readily available method that should be taken into account especially in cases with low initial visual acuity.
BACKGROUND: There is currently no effective therapy for retinal artery branch occlusion (RABO). Transluminal Nd:YAG embolectomy (TYE) was developed to achieve rapid reperfusion; however, it is still a subject of controversy. A Nd:YAG laser is focused on the occluded vessel, the vessel wall is ruptured and the embolism dislocates to the vitreous humor through the opening in the artery. METHOD: We retrospectively examined the results of five patients treated with TYE. RESULTS: The age of the patients was 26-75 years (mean age 58 years, median 68 years). Initial visual acuity was hand movements to 1.0 and all patients had visual field defects. Treatment was performed between 4 and 30 h from the onset of symptoms. Visual acuity improved markedly in two cases the next day (hand movements to 0.8 and 0.4 to 1.0) and final visual acuity was between 0.8 and 1.25. All treatments led to vitreous hemorrhage but only one patient required surgical treatment. The range of follow-up was 4-42 months. CONCLUSIONS: The results are in accordance with those published in the literature. It can be concluded that TYE is a fast, easy and readily available method that should be taken into account especially in cases with low initial visual acuity.
Authors: John O Mason; Ami A Shah; Rachel S Vail; Peter A Nixon; Edgar L Ready; James A Kimble Journal: Am J Ophthalmol Date: 2008-07-02 Impact factor: 5.258