[Radial optic neurotomy: efficacy monitoring using venous ophthalmodynamometry].
BACKGROUND
Retinal central venous outflow pressure (VOP) can be measured with a new ophthalmodynamometer (Meditron, Völklingen, Germany). Radial optic neurotomy (RON) is a new surgical approach for central retinal vein occlusion (CRVO) which is still controversially discussed. Particularly the early formation of retinochoroidal collaterals is intended to achieve normalization of the preoperatively increased pressure in the central retinal vein. We investigated the VOP after RON.


METHODS
In total, 21 eyes of 21 patients (9 male, 12 female) suffering from CRVO were treated by RON. Pars plana vitrectomy with nasal radial optic neurotomy and peeling of the internal limiting membrane were performed. The mean follow-up time was 10.8 months (6-24 months). Central venous outflow pressure was measured using ophthalmodynamometry.


RESULTS
The most frequent concomitant ophthalmic disease was glaucoma (52%), and the predominantly associated systemic disease was hypertension (81%). After RON in 16 eyes (76%) visual acuity improved by at least 2 lines; in 3 eyes (14%) visual acuity was unchanged (+/-1 line) and in 2 patients (10%) visual acuity decreased by 2 or more lines. Eyes with visual improvement and formation of chorioretinal anastomosis postoperatively showed a significantly lower venous outflow pressure assessed with ophthalmodynamometry.
Rauber
M
M
Augenklinik, Bundesknappschaft Sulzbach, An der Klinik 10, 66280 Sulzbach (Saar), Germany. RauberMartin@gmx.de
Müller
S
S
Mester
U
U
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D009898:Optic Disk / Q000098:blood supply; D009900:Optic Nerve / Q000601:surgery*; D012169:Retinal Vein / Q000601:surgery*; D012170:Retinal Vein Occlusion / Q000175:diagnosis* / Q000601:surgery*; D014065:Tonometry, Ocular / Q000379:methods*; D016896:Treatment Outcome; D014821:Vitrectomy / Q000379:methods*