Mariachiara Romagnoli, Stanislao Rizzo (Pisa, Italy)

Advantages: 

To evaluate, safety and anatomical and functional effectiveness of surgical embolus removal in branch retinal artery occlusion.

Methods: 

Retrospective study of four patients with branch retinal artery occlusion, occurring less than 36 hours before surgery.  All eyes underwent pars plana vitrectomy and a longitudinal incision of the anterior wall of the occluded arteriole in an attempt to remove the embolus.  A preoperative and postoperative comparison of visual acuity, fluorescein angiography and computerized visual field analysis was made.

Effectiveness / Safety:

Surgical removal of the embolus was achieved in all cases, visual acuity improved from a median of 20/100 to a median of 20/30 and reperfusion of the occluded vessel was angiographically confirmed in three of the four patients.  Surgical removal of retinal arterial emboli seems to be an effective and safe treatment for arterial retinal occlusion.

Take home message: 

Surgical removal of retinal arterial emboli appears to be an effective and safe treatment for arterial retinal occlusion.  Timing is the most important factor influencing outcome.  A randomised controlled clinical trial is needed to confirm our results.