Radial optic neurotomy for management of hemicentral retinal vein occlusion.
OBJECTIVE
To evaluate the effect of radial optic neurotomy on visual acuity (VA) and foveal thickness in patients with hemicentral retinal vein occlusion.


METHODS
A prospective noncomparative case series of 13 eyes in 13 patients with hemicentral retinal vein occlusion and a preoperative VA of 20/60 or less from a total of 232 retinal vein occlusions diagnosed. All patients underwent pars plana vitrectomy, posterior hyaloid dissection, and radial optic neurotomy at the nasal border of the optic disc.


RESULTS
Visual acuity and macular thickness were measured with optical coherence tomography. Nine patients (69.2%) gained 2 or more Snellen lines of vision, and in 4 patients (30.8%) VA improved by 4 or more Snellen lines (median visual acuity, 20/50; mean VA, 20/45; P<.01) (average gain, 2.7 Snellen lines). The decrease in foveal thickness was statistically significant (P<.01) (median decrease, 297 microm). Final VA was statistically related to decreased macular thickness at optical coherence tomography (P = .03; rho = -0.62). Retinochoroidal shunts developed in 6 patients (46.1%) at the radial optic neurotomy site. No surgical complications were observed.


CONCLUSIONS
Radial optic neurotomy seems to be a potential treatment in selected patients with hemicentral retinal vein occlusion, probably because of the more rapid appearance of retinochorioretinal collateral vessels, which promote faster resolution of macular edema.
Garcia-Arumi
Jose
J
Hospital Vall d'Hebron and Instituto de Microcirugia Ocular, Universidad Autonoma de Barcelona, C/Munner no. 10, 08022 Barcelona, Spain. 17215jga@comb.es
Boixadera
Anna
A
Martinez-Castillo
Vicente
V
Blasco
Hugo
H
Lavaque
Alejandro
A
Corcostegui
Borja
B