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.