Radial optic neurotomy for ischaemic central vein occlusion.
OBJECTIVE
Ischaemic central retinal vein occlusion (CRVO) accounts for 20-50% of all CRVO. No treatment has been proved to be effective. The efficacy of radial optic neurotomy (RON) was evaluated in eyes with ischaemic CRVO.


METHODS
10 patients with ischaemic CRVO underwent RON. After pars plana vitrectomy, a microvitreoretinal blade was used to incise the scleral ring, cribriform plate, and adjacent sclera at the nasal edge of the optic disc. Best corrected visual acuity (BCVA), intraocular pressure (IOP), fluorescein angiography (FA), multifocal electroretinography (mfERG), and optical coherence tomography (OCT) were measured preoperatively and at 1, 3, and 6 months postoperatively.


RESULTS
No visual improvement was noted in the eyes that underwent RON. FA and mfERG showed no increase in retinal perfusion or retinal function postoperatively. Mean macular central thickness changed from 841 (SD 170) mum preoperatively to 162 (SD 34) microm at the sixth postoperative month. One patient had retinal central artery perforation intraoperatively. One patient developed neovascular glaucoma.


CONCLUSIONS
RON in ischaemic CRVO did not improve visual function (by mfERG) or visual acuity although macular thickness did improve. This technique may be associated with potential risks. Randomised studies are needed to corroborate these results.
Martínez-Jardón
C S
CS
Retina Service, Hospital Dr Luis Sanchez Bulnes, Asociación Para Evitar la Ceguera en México, Vicente García Torres No 46, San Lucas Coyoacan 04030, México City, México.
Meza-de Regil
A
A
Dalma-Weiszhausz
J
J
Leizaola-Fernández
C
C
Morales-Cantón
V
V
Guerrero-Naranjo
J L
JL
Quiroz-Mercado
H
H
D000368:Aged; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods*; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007511:Ischemia / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D008266:Macula Lutea / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009900:Optic Nerve / Q000601:surgery*; D011446:Prospective Studies; D012170:Retinal Vein Occlusion / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy