Long-term effects of vitrectomy for persistent macular edema secondary to central retinal vein occlusion

1.Masanori Miyazaki
2.Mitsuru Arima
3.Yasutaka Mochizuki
4.Tatsuro Ishibashi

Kyushu University, Fukuoka, Japan

Purpose: To investigate long-term outcomes in eyes with refractory macular edema (ME) secondary to central retinal vein occlusion (CRVO) that underwent pars plana vitrectomy (PPV).

Methods: This retrospective study analysed the outcome of 10 patients (mean age: 66.2, 43-82) with intractable ME secondary to CRVO, who were resistant to various drug therapies. Standard 20G PPV with Brilliant blue G (BBG)-assisted inner limiting membrane (ILM) peeling and injection of 4mg Triamcinolone acetonide (TA) were performed in all patients. Best-corrected visual acuity (BCVA), foveal thickness (FT), and macular volume (MV) were measured before PPV and at 1, 3, 6, and 12 months postoperatively.　

Results: At one-month follow-up, FT and MV were significantly reduced and all OCT figures showed almost normal structures. However, all cases demonstrated recurring macular edema at 1.5-4 months (average: 2.85 months). Additional injections of Bevacizumab or TA were needed in 9 of 10 patients. BCVA (logMAR) were 0.59 before operation, and 0.54, 0.49, 0.50, and 0.54 at 1, 3, 6 and 12 months postoperatively.

Conclusions: PPV performed for persistent ME secondary to CRVO has the potential to reduce ME in the early postoperative phase, but ME was necessarily recurred in all cases. Additional medications were needed for keeping anatomical and visual improvements for a long period.