Translumental Nd:YAG Laser Embolysis for the Treatment of Branch Retinal Artery Occlusion

Abstract

Abstract Objective To investigate the clinical effect of translumental Nd:YAG laser embolysis(TYE) in the treatment of branch retinal artery occlusion(BRAO) for the patients with initial best corrected visual acuity(BCVA) no more than 20/100 and more than 24 hours from onset to visit. Material and Methods In this study, a total of 8 affected eyes(8 patients, 5 male and 3 female)with sight-threating BRAO received TYE therapy. All patients had a visible embolus within the affected eye. The mean age of the patients was 75.4 ± 6.3 years (range, 66–85 years). All the time from onset to initial visit to our hospital was more than 24 hours. The mean treatment time from onset were 7.4 ± 4.1 days (range, 2–14 days). Before the TYE treatment, the BCVA of all affected eyes was 20/100 or worse. All patients underwent BCVA test, fundus photography, optical coherence tomography(OCT), and central visual field(CVF) examination from the first to final visit. Results After the TYE treatment, all the cases showed immediate recovery of blood flow in the occluded branch retinal artery. The reperfusion of the blocked artery was observed in all affected eyes by fundus examination and fundus photography. The diameter of the affected branch retinal arteries increased significantly. The BCVA improved significantly by a average of 5.7 lines(rang 1–11 lines) in all patients. The BCVA of the affected eyes at the last follow-up were significantly improved compared before TYE treatment(P < 0.01). Before treatment the average MS was 11.2 ± 2.51, the average MS at the last follow-up time was 11.7 ± 3.55. There was no statistically significant difference in mean MS between pretreatment and at the last follow-up(P > 0.05). During the TYE treatment, mild retinal and vitreous hemorrhage usually happened which gradually absorbed in no more than 2 weeks. Conclusion Translumental Nd:YAG laser embolysis may be a safe and effective method to significantly improve the prognosis of BRAO in patients with initial BCVA no more than 20/100 and more than 24 hours from onset to visit.