Rajeev S Ramchandran1, Sharon Fekrat. 1. From the *University of Rochester Eye Institute, Rochester, New York; and †Duke University Eye Center, Durham, North Carolina.
Abstract
PURPOSE: To report one surgeon's experience in treating a case of branch retinal artery occlusion with pars plana vitrectomy and surgical removal of the etiologic retinal arterial embolus. METHODS: Single case presentation of pre- and postoperative visual acuity data, fluorescein angiography, and optical coherence tomography studies of one eye undergoing pars plana vitrectomy and retinal arterial embolectomy. RESULTS: Attempted embolectomy was unsuccessful in removing the retinal arterial embolus. Intraoperatively, the embolus traveled retrograde back into the central retinal artery when the infusion bottle was raised to maximum height. On postoperative Day 1, the embolus had returned to its preoperative position. However, postoperative arterial perfusion improved, as evidenced by fluorescein angiography, and macular edema was improved on the first postoperative day, as documented on optical coherence tomography. Visual acuity improved from 20/80 preoperatively to 20/32 at 1 month and to 20/20 at 9 months postoperatively, even though the affected retinal tissue had markedly thinned. CONCLUSION: This single case illustrates our experience with the vitreous surgical techniques of embolus extraction in an eye with a branch retinal artery occlusion and an ophthalmoscopically visible embolus.
PURPOSE: To report one surgeon's experience in treating a case of branch retinal artery occlusion with pars plana vitrectomy and surgical removal of the etiologic retinal arterial embolus. METHODS: Single case presentation of pre- and postoperative visual acuity data, fluorescein angiography, and optical coherence tomography studies of one eye undergoing pars plana vitrectomy and retinal arterial embolectomy. RESULTS: Attempted embolectomy was unsuccessful in removing the retinal arterial embolus. Intraoperatively, the embolus traveled retrograde back into the central retinal artery when the infusion bottle was raised to maximum height. On postoperative Day 1, the embolus had returned to its preoperative position. However, postoperative arterial perfusion improved, as evidenced by fluorescein angiography, and macular edema was improved on the first postoperative day, as documented on optical coherence tomography. Visual acuity improved from 20/80 preoperatively to 20/32 at 1 month and to 20/20 at 9 months postoperatively, even though the affected retinal tissue had markedly thinned. CONCLUSION: This single case illustrates our experience with the vitreous surgical techniques of embolus extraction in an eye with a branch retinal artery occlusion and an ophthalmoscopically visible embolus.