Author: Francisco Manuel Hermoso Fernandez
Co-authors: Jose Luis Garcia Serrano, Carmen Gonzalez Gallardo, Teresa Domech Serrano, Jose Enrique Muñoz de Escalona Rojas
Abstract
Purpose: The evaluation of the results of embolysis laser YAG photo-fragmentation over the branch retinal artery occlusion.Setting: Department of Ophthalmology of the San Cecilio University Hospital of Granada, Spain.
Methods: Case series. The description of Laser-YAG embolysis performed in 7 patients with BRAO caused by a visible cholesterol embolus. We portray the findings of the visual acuity, fundus examination, OCT and angiography. We also used the PubMed database to find other prospective or retrospective studies.
Results: Best corrected visual acuity (BCVA) at onset averaged 0.12 ( 1.31 LogMAR) and BCVA improved 0.86 ( 0.074 LogMAR) at last reported follow-up (avg. 6 months, p =0.003). In 100% of the cases, BCVA visual acuity post laser-YAG embolysis was ≥20/40 (LogMAR ≤ 0.3). The visual field gain measured by the reduction of the Mean Defect (MD) was not significant, on the day of embolysis 12,05 ± 3.17 Db vs. 6 months after treatment 9,97 ± 3.64 Db. As a complication, 3 patients presented vitreous hemorrhage, which did not require treatment.
Conclusions: Branch retinal artery occlusion (BRAO) causes nonperfused areas it results in ischemia and infarction of the retina, with loss of visual acuity and field. There is no effective therapy for BRAO. In the first 48 hours of BRAO, laser YAG embolysis in BRAO shows better results than natural history. Small gains in perfusion determine significant gains in visual acuity and limited visual field.
No financial disclosure.
