Em. Opremcak et al., Radial optic neurotomy for central retinal vein occlusion - A retrospective pilot study of 11 consecutive cases, RETINA, 21(5), 2001, pp. 408-415
Citations number
12
Categorie Soggetti
Optalmology
Journal title
RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES
Purpose: Retinal vascular occlusive disease is the second leading cause of
permanent retinal blindness. The etiology of central retinal vein occlusion
(CRVO) is not well understood. The anatomy of the optic disk including the
cribriform plate and scleral ring may contribute to the development of ret
inal vaso-oclussive diseases. Neurovascular compression within the confined
space at this location may play a pathoetiologic role in CRVO. The authors
performed radial optic neurotomy in patients with CRVO to relax this space
and relieve pressure on the central retinal vein.
Methods: Radial optic neurotomy (RON) was performed on 11 consecutive patie
nts with severe, hemorrhagic CRVO with visual acuities of 20/400 or less. A
microvitreoretinal blade was used to relax the scleral ring, cribriform pl
ate, and adjacent sclera of the optic disk. Reperfusion of the retina was a
chieved via decompressing the central retinal vein.
Results: Radial optic neurotomy was performed successfully in all 11 patien
ts. There were no complications noted with this procedure. All patients had
clinical improvement as determined by fundus examination, photography, and
fluorescein angiography. Postoperative visual acuities were equal or impro
ved in 82% of patients. Eight of the patients (73%) had rapid improvement o
f visual acuity with an average gain of five lines of vision.
Conclusions: Surgical decompression of CRVO via RON is a technically feasib
le and initially safe procedure that is associated with rapid reperfusion o
f the retina. Resolution of the intraretinal hemorrhage, edema, and ischemi
a may improve the visual prognosis in patients with this common retinal dis
order.