Long-term follow-up of a modified technique for laser-induced chorioretinal venous anastomosis in nonischemic central retinal vein occlusion.
OBJECTIVE
To evaluate the long-term outcomes of a modified technique for laser chorioretinal venous anastomosis in nonischemic central vein occlusion (CVO).


METHODS
Prospective, noncomparative, consecutive case series.


METHODS
Nineteen eyes of 19 patients.


METHODS
Nineteen consecutive eyes with nonischemic CVO were observed for a mean period of 48 months after attempted laser-induced chorioretinal venous anastomosis therapy using a technique modified intentionally to avoid vein wall rupture.


METHODS
Anastomosis patency, visual acuity, maintenance of nonischemic status, and complications were measured.


RESULTS
At least one patent anastomosis developed eventually in 19 of 19 eyes (100%). Two anastomoses developed in 5 of 19 eyes (26%). There were one or two nonfunctioning sites in 8 of 19 eyes (42%). The maximum number of treatment attempts in a single eye was four. Snellen visual acuity was unchanged in 3 of 19 eyes (16%) and improved from 1 to 11 lines (mean improvement, 5 lines) in 16 of 19 eyes (84%) during the mean follow-up period of 48 months. Nineteen of 19 eyes (100%) maintained nonischemic status. Treatment complications were limited to localized preretinal fibrosis.


CONCLUSIONS
Rupture of the vein wall is not required to form a functioning laser-induced chorioretinal venous anastomosis in eyes with nonischemic CVO. A technique modified intentionally to avoid vein wall rupture seems to be safer and more predicable.
Leonard
Brian C
BC
University of Ottawa Eye Institute, Ottawa, Ontario, Canada. bleonard@ottawahospital.on.ca
Coupland
Stuart G
SG
Kertes
Peter J
PJ
Bate
Rosario
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D002829:Choroid / Q000098:blood supply* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012169:Retinal Vein / Q000473:pathology / Q000601:surgery*; D012170:Retinal Vein Occlusion / Q000175:diagnosis / Q000601:surgery*; D014792:Visual Acuity