LASER-INDUCED CHORIORETINAL VENOUS ANASTOMOSIS TREATMENT OF NONISCHEMIC CENTRAL RETINAL VEIN OCCLUSION

Objectives: To determine whether a chorioretinal venous anastomosis co uld be created in humans and to evaluate the influence this has on pat ients with nonischemic central retinal vein occlusions in whom progres sive visual loss developed. Design: Retrospective study. Patients: A t otal of 24 patients with nonischemic central retinal vein occlusions a nd progressive visual loss. Intervention: An attempt was made to creat e a chorioretinal venous anastomosis using laser photocoagulation to e nable obstructed venous blood to enter the choroid, thus bypassing the site of occlusion. Main Outcome Measures: Visual acuity, fundoscopic appearance, and rapid sequence fluorescein angiograms. Results: A succ essful chorioretinal venous anastomosis was created in eight cases (33 %), with improvement in visual acuity and resolution of the funduscopi c appearance of venous occlusion in all fight cases. Of the 16 patient s (67%) in whom an anastomosis was not successfully created, the ische mic form of central retinal vein occlusion developed in five (31%), an d eight (50%) were left with various degrees of macular damage and red uced visual acuity. Conclusions: Peripheral chorioretinal venous anast omoses can be created in a nonischemic central retinal vein occlusion and appear to be well tolerated. This technique may have some value in the treatment of patients with this condition; however, to address th is fully, a properly constructed randomized prospective clinical trial will need to be performed.