| Objective : Retinal vein occlusion (RVO) is one of the common vascular disorders of the retina in clinical practice. The occurrence of this disease often associate with hypertension, hyperlipidemia, hyperglycemia, arteriosclerosis, and artery ischemia. The patients'visual acuity may deteriorate in a majority of eyes because of macular edema (ME) and retinal new vessel (RNV). Retinal laser photocoagulation is a vailable therapy for RVO. It could close retinal capillary non-perfusion area, prevent neovascularization, promote neovascularization atrophy, and control secondary injury caused by neovascularization. The goal and method of retinal laser photocoagulation are different for different types of RVO. Before laser photocoagulation fundus fluorescein angiography (FFA) and ophthalmology B-ultrasound should be examined in order to make clear with or without non-perfusion area and neovascularization. At the same time observe the relationship between the vitreous and retina in order to choose appropriate retinal laser photocoagulation treatment. Vitreous hemorrhage may occur from few days to few months if the opportunity or the method of laser photocoagulation was inappropriate. Minor vitreous hemorrhage can be absorbed while massive vitreous hemorrhage usually be absorded difficultly which affects the visual acuity seriously. Furthermore, massive vitreous hemorrhage can cause traction retinal detachment because of hemorrhage organization. Vitrectomy can treat RVO accompanied by vitreous hemorrhage and traction retinal detachment. This study was designed to investigate the mechanism of vitreous hemorrhage in patients with RVO after laser retinal photocoagulation and seek reasonable corresponding measures.Methods : To analyze the etiology of vitreous hemorrhage in patients with RVO after laser retinal photocoagulation (16 eyes of 16 cases). The course of disease of vitreous hemorrhage ranged from 8 days to 5 months (mean 1.99 months). All eyes were treated with vitrectomy with intraoperative laser photocoagulation. We mainly observe eyes which with or without posterior vitreous detachment (PVD), vitreous hemorrhage organization, retinal detachment and fibrovascular membranes during the operation. The average postoperative follow-up is longer than 6 months. The major observation items before and after operation included best correct visual acuity (BCVA), intraocular pressure (IOP), anterior segment, fundus examination, ophthalmology A-mode ultrasound and B-mode ultrasound, fundus fluorescein angiography (FFA) and operative complications.Results : 1 Patients'best correct visual acuity before surgery, hand movement are 9 eyes, index / at the front of eyes are 5 eyes, 0.01~0.05 is one eye, 0.06~0.1 is one eye. 16 eyes(100%) had BVCA of 0.1 or better after surgery . There was a significant difference in statistical significance compared with pre-operation (P<0.01). Follow-up time was 6~18 months, and the patients'disease conditions stable.2 Postoperative BVCA were divided into 3 groups according to 0.1~0.15, 0.2~0.25, 0.3~0.5. Groups of course of vitreous hemorrhage≤3 months and course of vitreous hemorrhage>3 months are used to be compared. There was no difference in statistical significance compared with these two groups (P>0.05).3 9 eyes (56.25%) existed vitreous and retinal adhesions after resecting vitreous opacification during the operation. 4 eyes(25.00%) existed inappropriate retinal laser photocoagulation treatment. 3 eyes (18.75%) existed the shrinkage and traction of fibrovascular membranes. 16 eyes of 16 cases were no occurrence of vitreous hemorrhage in follow-up period.4 one eye (6.25%) complicated with iatrogenic retinal hole during operation. It was formed at stripping membrane, separating vitreous and retinal punctuate adhesions. Finally, iatrogenic retinal detachment didn't occur after photocoagulation retinal hole.Conclusions : 1 The main cause of vitreous hemorrhage in patients with RVO after laser retinal photocoagulation is vitreous and retinal some adhesion. Inappropriate laser photocoagulation therapy and the shrinkage and traction of fibrovascular membranes are secondary causes.2 The inducement of vitreous hemorrhage in patients with RVO after laser retinal photocoagulation is inappropriate timing and mode of laser retinal photocoagulation.3 That vitrectomy for vitreous hemorrhage in patients with RVO after laser retinal photocoagulation accompanied by part of PVD or combined with fibroblast proliferation could avoid the recurrence of vitreous hemorrhage.
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