Richard Luscan (Paris, France)

Advantages:

There is extensive literature about the vascular component of the etiopathogenesis of AMD. Lutty brought histopathological evidence that in wet AMD, choriocapillaris (CC) disturbances precede RPE atrophy (2009). Bonnet was the first to perform Vortex Vein Occlusion (VVO) for wet forms of AMD in 17 human eyes (1983). Hayreh then Ducournau demonstrated that CC veins have a latent capacity of blood supply: occlusion of two VV is likely to induce 35 to 50% refilling of the CC; increased CC turgescence is likely to improve, at least qualitatively, the choroidal flow and metabolic exchanges in tissues via increase of hydrostatic pressure and surface exchanges. We started VVO in 2002.

Methods:

In 2006 we reported a prospective consecutive case series of 6 eyes in 4 patients with soft drusen: 5 eyes of 4 patients were operated with VVO and 1 eye in 1 patient with bilateral and symmetrical drusen served as a control. We report here the mid-term follow up, from 4 to 6 years. Best corrected visual acuity (BVCA), biomocroscopic examination, fluorescein angiography (Heidelberg SLO), OCT 3 (Zeiss) were repeated every 6 months.

Effectiveness / Safety:

In 2006 we reported a prospective consecutive case series of 6 eyes in 4 patients with soft drusen: 5 eyes of 4 patients were operated with VVO and 1 eye in 1 patient with bilateral and symmetrical drusen served as a control. We report here the mid-term follow up, from 4 to 6 years. Best corrected visual acuity (BVCA), biomocroscopic examination, fluorescein angiography (Heidelberg SLO), OCT 3 (Zeiss) were repeated every 6 months.

Take home message:

Surgical VVO might be a durable treatment to prevent the progression of drusen at risk.