gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Radial optic neurotomy as treatment for central retinal vein occlusion

Meeting Abstract

Suche in Medline nach

  • corresponding author H. Hasselbach - Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Opthalmologie, Kiel
  • A. Bunse - Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Opthalmologie, Kiel
  • J. Roider - Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Opthalmologie, Kiel

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogFR.01.05

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dog2004/04dog166.shtml

Veröffentlicht: 22. September 2004

© 2004 Hasselbach et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Radial optic neurotomy has been proposed to effectively alleviate the compartment syndrome at the level of the lamina cribrosa which is discussed to play a pathoetiologic role in central retinal vein occlusion.

Methods

Pars plana vitrectomy with a radial incision of the lamina cribrosa, the scleral rim and the adjacent sclera was performed on the nasal side of the optic nerve in 11 patients (mean age: 71 years; range: 45-85). Pre- and postoperatively fluorescein angiographs using the Heidelberg Retina Angiograph (HRA) were evaluated.

Results

Mean duration of symptoms prior to surgery was 14 days (3-36). The mean follow-up was 5 months (1-9). Visual acuities improved in 5/11 patients (>2 lines), 4/11 worsened. Complications noted were: vitreous hemorrhage (n=1) and neovascular glaucoma (n=1). Segmental visual field loss suggesting damage to retinal nerv fibers adjacent to the neurotomy was seen in 2/5 cases. Evaluations of the retinal nerv fiber layer thickness measured by OCT in a 3.4mm circle centered on the optic disc documented in 3/4 cases postoperatively a reduction on the site of the neurotomy. Fluorescein angiographs revealed partly voluminous shunt vessels on the nasal rim of the optic disc in 5/6 eyes. All patients had a significant reduction of venous congestion (direct measurements on the FLA-image: 0.22 to 0.17mm in average), papillary leakage and intraretinal hemorrhage. One patient who showed an initial venous non-perfusion in the fluorescein angiography changed to a perfused status after 2 months.

Conclusions

Few complications were noted with radial optic neurotomy as treatment for central retinal vein occlusion. In fact a couple of patients showed an improvement of visual acuity which was clearly higher than expected by the natural history of the disease alone. Therefore further evalutions of this procedure are appropriate.