Embolus-induced branch retinal artery occlusion with a presenting best-corrected visual acuity of <6/12 and visual field defect: yag embolectomy safely restores arteriolar perfusion and/or visual function

Tsui-Kang Hsu; Shih-Jen Chen; Jianqin Lei; Zhifeng Wu; Chih-Ching Lin; Mi-Mi Chen; Tai-Chi Lin; Jorn-Hon Liu; Hsiao-Ming Chao

doi:10.1097/ICB.0b013e3182852370

Embolus-induced branch retinal artery occlusion with a presenting best-corrected visual acuity of <6/12 and visual field defect: yag embolectomy safely restores arteriolar perfusion and/or visual function

Retin Cases Brief Rep. 2013 Summer;7(3):210-6. doi: 10.1097/ICB.0b013e3182852370.

Authors

Tsui-Kang Hsu¹, Shih-Jen Chen, Jianqin Lei, Zhifeng Wu, Chih-Ching Lin, Mi-Mi Chen, Tai-Chi Lin, Jorn-Hon Liu, Hsiao-Ming Chao

Affiliation

¹ *Department of Ophthalmology, Cheng Hsin General Hospital, Taipei, Taiwan, Republic of China; †Department of Ophthalmology, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China; ‡Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China; §Department of Ophthalmology, First Affiliated Hospital of Medical School of Xi'an Jiaotong University, Shaanxi, Republic of China; ¶Department of Ophthalmology and Visual Sciences, People's Hospital, Jiangsu, Republic of China; **Department of Nephrology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China; ††Institute of Pharmacology, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.

PMID: 25391108
DOI: 10.1097/ICB.0b013e3182852370

Abstract

Purpose: To study the effects of translumenal Nd:YAG embolectomy (TYE) on the visual functions of patients presenting with decreased vision (<6/12) and visual field defect (VFD) from embolus-induced branch retinal artery occlusions.

Methods: Case reports.

Results: The initial information available for five Chinese patients consisted of best-corrected visual acuity, visual field, and the branch retinal artery embolus location/laterality. These consisted of Case 1 (6/15; 3-day upper VFD; temporal lower first bifurcation; left eye), Case 2 (6/120; 1-week upper VFD; macular edema; disk; right eye), Case 3 (6/30; 1-week upper VFD; temporal lower first bifurcation; left eye), Case 4 (6/60; 1-day lower VFD; temporal upper first bifurcation; left eye), and Case 5 (counting finger; temporal upper first bifurcation; left eye). In all five cases, a fluorescein angiogram showed delayed arteriolar filling. At approximately 2 weeks after a single TYE treatment (Cases 1, 3, and 5) or a double TYE treatment (Case 4), fluorescein angiogram showed restoration of arteriolar perfusion. Furthermore, the patients' visual field and MP-1 sensitivity reductions were attenuated in Cases 1, 3 and 4, and their best-corrected visual acuities had improved to 6/10 (Case 1), 6/7.5 (Case 3), 6/6 (Case 4), and 6/60 (Case 5). In Case 2, 2 TYE treatments combined with Avastin and Kenacort also improved her situation despite persistent macular edema with the best-corrected visual acuity further increasing to 6/7.5.

Conclusion: Conclusively, TYE is a safe and effective procedure that can be used to treat eyes with embolus-induced branch retinal artery occlusion with a presenting best-corrected visual acuity of <6/12 and visual defect.