Article
Morphological and functional results after radial optic neurotomy in patients with central retinal vein occlusion
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Authors
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C. Gerth
- Augenabteilung, St. Franziskus Hospital Münster
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G. Spital
- Augenabteilung, St. Franziskus Hospital Münster
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D. Pauleikhoff
- Augenabteilung, St. Franziskus Hospital Münster
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A. Lommatzsch
- Augenabteilung, St. Franziskus Hospital Münster
| Published: | September 22, 2004 |
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Outline
Text
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.
