Pars plana vitrectomy with ILM peeling for macular edema secondary to retinal vein occlusion

To evaluate anatomic and functional results in patients with macular edema in retinal vein occlusion (RVO), treated with pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling, depending on the timing of surgery.

A total of 35 consecutive patients underwent PPV with ILM peeling. Visual acuity, fluorescein angiography, and optical coherence tomography/spectral optical coherence tomography were performed preoperatively and 6-12 months postoperatively.

Anatomic improvement was achieved in 29 patients (82.9%). In 6 patients, there was no improvement. Central macular thickness decreased in 17 patients (48.6%) with central retinal vein occlusion (CRVO) and in 12 patients (34.3%) with branch retinal vein occlusion (BRVO) (p<0.05). A total of 68% of eyes showed improvement in visual acuity (p<0.05). Visual acuity improved in 14 patients (mean 3.7 Snellen lines) with CRVO and in 10 patients ( mean 3.7 Snellen lines) with BRVO. The t test shows no statistically significant difference in visual acuity improvement between ischemic and nonischemic CRVO (p>0.05) or between ischemic and nonischemic BRVO (p>0.05). Better results were observed in patients treated within 1 month of the onset of symptoms than in patients treated after more than 1 month. The difference is statistically significant (t test, p=0.0016).

PPV with ILM peeling may improve anatomic and functional prognosis in patients with macular edema secondary to RVO. Vitrectomy with ILM peeling seems to be beneficial for macular edema secondary to RVO in patients treated within 1 month from the onset of symptoms. PPV with ILM peeling in ischemic RVO and nonischemic RVO improves visual acuity.