The European Arteriovenous Sheathotomy Trials „EAST“
Carsten H. Meyer for the EAST-group (Marburg)
Branch retina vein occlusion (BRVO) usually occur due to a thrombosis at the arteriovenous
(AV)-crossing. An arteriosclerotic retinal artery may compress the adjacent retinal vein within
the surrounding adventitial sheath. A surgical decompression may eliminate this primary cause
improving the perfusion and retinal function in selected patients.
EAST is designed as an open, prospective, randomized, multicenter study with two arms: The
first subgroup (EAST I) compairs vitrectomy including AV-sheathotomy with an untreated control
group. The second subgroup (EAST II) investigates BRVO-patients, who received a vitrectomy
or without additional AV-sheathotomy. The examination prior to surgery and at 1, 3 and 6
months postoperatively include ETDRS visual acuity (VA), fluorescence angiography (FA),
Goldmann visual flied testing, and optical coherent tomography (OCT). Inclusion criteria are
duration < 3 months, VA < 0.3, visible AV-crossing at the BRVO. Exclusion criteria are other
retinal pathologies including age-related macular degeneration (AMD), uveitis, diabetic maculopathy, or the functional better
eye.
The effectiveness of this new treatment approach is currently investigated at 10 centers in Germany, Austria and Spain.
AV-decompression may resolve the primary cause and improve vision in selected patients. The enrollment in both studies is
currently on its way.