Massive hemorrhagic retinal detachment during radial optic neurotomy.
BACKGROUND
We encountered obvious arterial bleeding from the incision site during radial optic neurotomy (RON) in a 55-year-old woman with central retinal vein occlusion (CRVO) and report the findings herein.


METHODS
The patient initially demonstrated a retinal hemorrhage and macular edema due to a left CRVO. Her corrected visual acuity was 0.5 OS. Since her symptoms did not improve and were aggravated, even though she received an oral anticoagulant drug orally, RON was performed 2 months after the onset of symptoms. During surgery, obvious arterial bleeding started from the RON incision site and it was not arrested although the infusion bottle was fully elevated. However, a subsequent infusion of liquid perfluoro-carbon successfully stopped the bleeding by direct pressure. Hemorrhagic retinal detachment occurred in the nasal quadrant and postoperative vitreous hemorrhage was treated surgically. The hemorrhagic retinal detachment was gradually absorbed and replaced by fibrous scar tissue. Two years after the surgery, no expansion of retinal detachment has been observed and corrected visual acuity is being maintained at 0.2 OS.


CONCLUSIONS
We conclude that RON for CRVO carries a risk of arterial bleeding and that infusion of liquid perfluoro-carbon seems to be effective to arrest arterial bleeding from the RON site.
Takaya
Kaori
K
Department of Ophthalmology, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
Suzuki
Yukihiko
Y
Nakazawa
Mitsuru
M
D019299:Decompression, Surgical / Q000009:adverse effects*; D005260:Female; D005466:Fluorocarbons / Q000627:therapeutic use; D006488:Hemostasis, Surgical; D006801:Humans; D008875:Middle Aged; D009900:Optic Nerve / Q000601:surgery*; D012163:Retinal Detachment / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012170:Retinal Vein Occlusion / Q000601:surgery*
D005466:Fluorocarbons