Background: Arteriovenous dissection (sheathotomy) is a new therapeutic option in patients with branch retinal vein occlusion (BRVO) and macular involvement. We present an angiographic follow-up of 22 patients who underwent arteriovenous dissection (AVD). Methods: Twenty-two patients (15 women; mean age 68.7±8.0 y ears) were examined preoperatively and 6 weeks, 3 months, 6 months, and 1 year a fter AVD. For assessment of retinal hemodynamics, arteriovenous passage time (AV P) of the affected and unaffected branches at first (AVPe) and at maximal (AVPma x) venous filling were measured. Changes in the foveal avascular zone (FAZ)were calculated to determine foveal structural changes. Visual acuity was assessed as functional parameter. Results: The early AVP (AVPe) of the affected branch incr eased from 4.4±0.8 s preoperatively to 4.9±0.6 s 6 weeks after surgery and dec reased to 2.7±0.4 s 1 year after surgery (p=0.05). When compared to the unaffec ted control branch, AVPe was significantly increased in the affected branch preo peratively (4.5±0.8 s versus 1.5±0.2 s, p< 0.01), 6 weeks (4.9±0.6 s versus 2 .1±0.3 s, p< 0.01), 3 months (2.7±0.4 s versus 1.5±0.2 s, p < 0.01), and 6 mo nths (3.1±0.4 s versus 2.2±0.3 s, p=0.02) after AVD. After 1 year, AVPe no lon ger differed between the affected and the control branch (2.7±0.4 s versus 2.6 ±0.3 s). AVPmax was significantly increased in the affected branch preoperative ly (11.8±0.8 s versus 7.7±1.0 s, p < 0.05). The AVPmax in the affected branch with the exception of 3 months after surgery (10.2±1.1 s, p < 0.01) was no long er elevated when compared to preoperative values. The area of the FAZ did not ch ange significantly but showed a trend for enlargement. Conclusion: AVD for decom pression of BRVO leads to a significant decrease of AVP and may ameliorate retin al perfusion in the affected branch.
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