Embolus-induced branch retinal artery occlusion with a presenting best-corrected visual acuity of <6/12 and visual field defect: yag embolectomy safely restores arteriolar perfusion and/or visual function.

PURPOSE: To study the effects of translumenal Nd:YAG embolectomy (TYE) on the visual functions of patients presenting with decreased vision (<6/12) and visual field defect (VFD) from embolus-induced branch retinal artery occlusions. METHODS: Case reports. RESULTS: The initial information available for five Chinese patients consisted of best-corrected visual acuity, visual field, and the branch retinal artery embolus location/laterality. These consisted of Case 1 (6/15; 3-day upper VFD; temporal lower first bifurcation; left eye), Case 2 (6/120; 1-week upper VFD; macular edema; disk; right eye), Case 3 (6/30; 1-week upper VFD; temporal lower first bifurcation; left eye), Case 4 (6/60; 1-day lower VFD; temporal upper first bifurcation; left eye), and Case 5 (counting finger; temporal upper first bifurcation; left eye). In all five cases, a fluorescein angiogram showed delayed arteriolar filling. At approximately 2 weeks after a single TYE treatment (Cases 1, 3, and 5) or a double TYE treatment (Case 4), fluorescein angiogram showed restoration of arteriolar perfusion. Furthermore, the patients' visual field and MP-1 sensitivity reductions were attenuated in Cases 1, 3 and 4, and their best-corrected visual acuities had improved to 6/10 (Case 1), 6/7.5 (Case 3), 6/6 (Case 4), and 6/60 (Case 5). In Case 2, 2 TYE treatments combined with Avastin and Kenacort also improved her situation despite persistent macular edema with the best-corrected visual acuity further increasing to 6/7.5. CONCLUSION: Conclusively, TYE is a safe and effective procedure that can be used to treat eyes with embolus-induced branch retinal artery occlusion with a presenting best-corrected visual acuity of <6/12 and visual defect.