First Author: N.Sato JAPAN
Co Author(s): N. Tsuchida K. Ishii
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An avulsed retinal vessel without a retinal break can be a source of repeated vitreous haemorrhage. Photocoagulation and scleral buckling had been previously proposed to treat the avulsed retinal vessel syndrome. We report our experience using the 25-gauge vitrectomy system for treating a case with recurrent vitreous haemorrhage secondary to an avulsed retinal vessel without a retinal break.
Showa General Hospital
A 84-year-old female presented with floaters and blurred vision in her left eye. The visual acuity was 20/20 in the right eye and 20/40 in the left eye. Anterior and intermediate segments were normal with mild cataract. Dilated fundus examination revealed vitreous haemorrhage with an avulsed retinal vessel without an associated retinal break at the superotemporal equator in her left eye. Although several photocoagulation treatments were tried in the past , she experienced repeated vitreous haemorrhages in her left eye. After discussing the treatment options, it was decided to perform vitrectomy.
Twenty-five-gauge vitrectomy combined with phacoemulsification and intraocular lens implantation was performed. A posterior vitreous separation was found. The avulsed vessel was ruptured during core vitrectomy. Endodiathermy was not applied and no tamponade was used at the end of the surgery. One week later visual acuity improved to 20/20. Six months later the patient remained symptom free.
Vitrectomy can be an effective treatment, offering significant rapid visual recovery in patient with vitreous haemorrhage secondary to an avulsed vessel.