[Does radial optical neurotomy have a place in the treatment of central retinal vein occlusion?].
BACKGROUND
the goal is to evaluate the anatomical (macular edema) and functional (visual acuity) efficacy of radial optic neurotomy in central retinal vein occlusion.


METHODS
the retrospective study is dealing with 15 eyes treated with radial optic neurotomy and at least a 6-month follow-up. The main study parameters are the visual acuity, the characteristics of the vein occlusion with fluorescein angiography, and those of the macular edema with optical coherence tomography.


RESULTS
mean preoperative visual acuity was 0.07 (0.003-0.4). At 6 months, mean visual acuity was 0.12 (0.003-0.3) for 14 cases, one eye being blind. Visual acuity was improved in 4 cases (26%), deteriorated in 2 cases and equal in 9 cases. Preoperative fluorescein angiography showed a perfused form in 9 cases and an ischemic one in 6 cases. At 6 months, fluorescein angiography was available in 12 out of the 15 cases. It showed ischemia in 4 cases, macular edema in 4 cases, a scarred macula in 2 cases. The posterior pole was hidden by blood in the last 2 cases. Optical coherence tomography was performed preoperatively and at 6 months in 8 out of the 15 cases. It showed macular edema in every case preoperatively. At 6 months, there was a worsening in 2 cases (25%), an improvement in 4 cases. In 2 cases, edema was replaced by a macular scar.


CONCLUSIONS
at 6 months, this study shows any improvement of the visual acuity in 26% of the cases. This result does not allow us to conclude that optical radial neurotomy has any role to play in the treatment of central retinal vein occlusion.
Gribomont
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AC
Service d'Ophtalmologie, Cliniques Universitaires St-Luc UCL, Avenue Hippocrate, 10, 1200 Bruxelles. gribomont@ofta.ucl.ac.be
Charlier
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D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D008269:Macular Edema / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D012170:Retinal Vein Occlusion / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity