Estudio de los índices del campo visual en el tratamiento de las obstrucciones de rama venosa temporal con fotocoagulación láser
Objective: to evaluate the behaviour of the campimetric indexes (IC) in retinal temporal branch vein occlusions (ORVTR) after laser photocoagulation (FCG) with the new programs of campimetric measurement. Material and method: 182 cases of OVRTR from January 1991 to January 2001 with the following criteria of FCG: oedematous forms with hard exudates, macular oedema and visual acuity (AV) inferior to 0,5; with AV superior to 0.5 if the campimetry indicates loss of retinal sensitivity, or absolute escotoma. Mixed forms with such previous criteria and if retinal ischemia (RI) is superior to 5 disc diameters (dd). Ischemic forms if RI is superior to 5 dd with/without new vessels. We excluded patients with alteration of the anterior chamber, retina affected by its systemic pathology, not transparent vitreous, campimetric reliability index more than 10% and patients who failed the controls, we obtained 68 OVRTR. When the angiography (AGF) does not demonstrate diffusion the last visual field is made. We studied 36 data, among them the IC: Average Sensitivity (MS), Average Defect (MD), Variance of the loss (LV), Variance of the corrected loss (CLV). Study in four phases: descriptive, evolution of the variables after the processing, valuation of factors prognoses and agreement between change in MS and change in AVL. Results: we see that the average age is 63.5 years, the distant visual acuity (AVL) of 0.22 and the next visual acuity (AVP) of 5,03. A 68.20% are women. The most frequent symptom (30,44%) is progressive diminution of the AV. The most important personal antecedent is hypertension (HTA). There is 69% of emetropy. The more affected temporal venous branch (65%) is the superior. The fellow eye presents obstructive pathology in a 10%. The vitreous has complete loosening in 59%. 59% of the OVRTR are RI, with 93% with RI superior to 5 dd. Only a 7% respect the fovea and a 41% have the 4 affected quadrants of the perifoveal arcade. We needed in 57,35% 2 sessions FCG. We observe that AVP and AVL improve (p<0,001). MS and MD remain stable (p<0,001). LV and CLV increase (p<0,001). The hypertensive ones increase the AVL (p=0,003) and the diabetics (DM) the AVP (p=0,01). Those with HTA (p=0,05) and progressive diminution of AV (p=0,01) lose MS and increase to MD. Aged patients (p=0,01) and men (p=0,007) increase LV and CLV. We observe that with 55.5 years 91.3% of the eyes improve in more than 2 lines their AVL after FCG. Agreement between MS and AVL does not exist except in patients with 52 years (p=0,03), intraocular pressure of 10.4 mmHg (p=0,05), men (p=0,03) and history of HTA (p=0,008). Conclusion: after FCG MS it diminishes and MD, LV and CLV increase. After FCG AV it increases in OVRTR that respect the fovea and diminishes with the affected perifoveal arcade. The AVP improves less in OVRTR with nervous fibber infarct. The HTA and the DM are favourable factors of the functional answer to the FCG.
Advisor:Daniel Vilaplana; Antonio Navarro
School:Universitat Autónoma de Barcelona
Source Type:Master's Thesis
Keywords:416 departament de cirurgia
Date of Publication:04/09/2002