Article
Morphological and functional results after radial optic neurotomy in patients with central retinal vein occlusion
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Published: | September 22, 2004 |
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Outline
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Objective
To evaluate the postoperative outcome after radial optic neurotomy (RON) in patients with central retinal vein occlusion (CRVO) by means of functional, electrophysiological and morphological tests.
Methods
Inclusion criteria: Central retinal vein occlusion with advanced optic disc oedema, macula oedem and intraretinal haemorrhages; age >40 years, duration of symptoms: ≤3 months, Visual acuity ≤0.2. Visual acuity (VA), slit lamp examination, ophthalmoscopy, fluorescein angiography (FA), OCT and, in a subset of patients, VEP and fullfield ERG (ISCEV standard) were performed prior to the RON and at the follow-up visits. RON was performed conventionally [1] in 23/26 and in 25 Gauge technique in 3/26 patients.
Results
So far, 26 patients (12 F, 14 M; mean age 60 yrs.) underwent RON. The follow-up periods were 1, 3, 6 and 12 months in 4, 6, 9 and 1 patients. VA increased in10/20 (50%), in 32% of the patients VA was ≥0.3. At the follow-up visits, VEPs showed a faster P100 latency and scotopic and photopic ERG showed increased and faster responses in all patients tested, even in the one patient with a 'negative' ERG prior to the operation. OCT demonstrated a reduction in macular edema. Neither of the patients developed rubeosis iridis or severe retinal ischemia. Postoperative complications such as bleeding in the vitreous cavity or retinal detachment were seen in 5/26 and 2/26 patients.
Conclusions
The RON is an efficient operation technique to reduce the venous congestion in CRVO. 50% of the patients experienced a visual rehabilitation. Scotopic and photopic retinal function improved in all patients tested. The VEP improvement excludes an optiv nerve damage due to the operation technique.