Controversies in the pathogenesis of RVO – Local perspective

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BRVO usually occurs at an arteriovenous (AV) crossing site, where a common adventitial sheath binds the artery and vein together. Several findings seem to demonstrate that vitreoretinal traction might have a significant role in some cases of BRVO. This prospective observational case-control study, with SD-OCT directed to the occlusion site, analyzed the prevalence of vitreoretinal traction in twenty BRVO patients. The results showed a true vitreoretinal traction in 7 eyes (35%). 5 eyes (25%) were associated with an adherence of posterior hyaloids without signs of retinal traction, whereas 8 eyes (40%) had neither vitreoretinal adherence nor vitreous traction. Regarding the same vessel segment of the fellow eye, none of the cases (0%) revealed vitreoretinal traction in the correspondent AV crossing site; 9 cases (45%) presented vitreoretinal adherence; and the remaining 11 cases (55%) showed neither traction nor adhesion. Chi-square analysis indicated that vitreovascular traction in the occlusion site was significantly associated with BRVO (p<0.05). In conclusion, a common firm vitreoretinal adhesion at the obstruction site is reported herein, pointing out the role of vitreovascular traction in the etiology of some cases of BRVO.

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