title: Radial optic neurotomy in central retinal vein occlusion: comparison of outcome in younger vs older patients.
abstract: OBJECTIVE
  To evaluate the effectiveness of radial optic neurotomy (RON) for central retinal vein occlusion (CRVO) in patients < or =50 years of age (group 1) vs those >50 (group 2).
  
  
  METHODS
  Prospective, interventional, comparative case series.
  
  
  METHODS
  The study included 43 consecutive patients with CRVO and preoperative visual acuity (VA) < or =0.70 logarithm of minimal angle of resolution (logMAR). All patients underwent pars plana vitrectomy and RON at the nasal border of the optic disk. VA and optical coherence tomography (OCT) findings were recorded preoperatively and at one, six, and 12 months postoperatively.
  
  
  RESULTS
  Systemic hypertension, diabetes, and open-angle glaucoma were statistically significantly more prevalent in group 2 (P < .05). One patient in group 1 had hyperhomocysteinemia, and had another antiphospholipid syndrome. Fifty percent of patients in group 1 gained > or =3 lines of Early Treatment Diabetic Retinopathy Study (ETDRS) vision, vs 33% in group 2. Mean final VA was 0.5 logMAR VA in group 1 vs 0.8 in group 2 (P = .04). Foveal thickness decreased significantly in both groups (P < .001). Ten patients (55.6%) in group 1 and 13 (54.2%) in group 2 developed retinochoroidal collaterals.
  
  
  CONCLUSIONS
  Underlying systemic disease does not seem to be an important factor in the pathogenesis of CRVO in younger patients, and thrombophilia was present in only 11% of patients in this age group. RON yielded better functional results in younger patients, although functional improvement remained limited in those with low baseline VA.
authors.affiliation: Hospital Vall d'Hebrón, Universidad Autónoma de Barcelona, 08022 Barcelona, Spain. 17215jga@comb.es
authors.forename: Jose
authors.initials: J
authors.lastname: Garcia-Arumi
authors.forename: Anna
authors.initials: A
authors.lastname: Boixadera
authors.forename: Vicente
authors.initials: V
authors.lastname: Martinez-Castillo
authors.forename: Marc
authors.initials: M
authors.lastname: Montolio
authors.forename: Alicia
authors.initials: A
authors.lastname: Verdugo
authors.forename: Borja
authors.initials: B
authors.lastname: Corcóstegui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D048909:Diabetes Complications; D005260:Female; D005902:Glaucoma, Open-Angle / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D009887:Ophthalmoscopy; D009898:Optic Disk / Q000098:blood supply / Q000601:surgery*; D009900:Optic Nerve / Q000601:surgery*; D011446:Prospective Studies; D012170:Retinal Vein Occlusion / Q000503:physiopathology / Q000601:surgery*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy