Long-Term Outcomes of Radial Optic Neurotomy With or Without Adjunctive Intraocular Triamcinolone Acetonide in Central Retinal Vein Occlusion

Abstract

Purpose: : To evaluate the long-term effect of radial optic neurotomy (RON) with or without adjunctive intraocular triamcinolone acetonide (TA) for central retinal vein occlusion (CRVO).

Methods: : Retrospective, non-randomized, comparative, consecutive case series. Thirty eyes of 30 patients underwent RON with or without an intraoperative injection of TA (10mg) into the vitreous cavity. Twenty-two eyes with adjunctive intraocular TA (TA group) were compared with 8 eyes without adjunctive intraocular TA (Non-TA group). The outcome measures were visual acuity and clinical appearance of macular edema evaluated with optical coherence tomography.

Results: : The age of patients ranged from 48 to 83 years (average 67 years) and follow-up period after surgery ranged from 12 to 49 months (average 21 months). There was no statically significant difference in visual acuity between the two groups at the final visit but postoperative visual acuity significantly improved in Non-TA group (p=0.01). On the other hand, postoperative visual acuity in TA group did not improve significantly (p=0.18). Recurrence of macular edema was not seen in Non-TA group but developed in 12 eyes (54.5%) of TA group (p=0.02). At final visit, macular edema was completely absorbed in 8 eyes (36.4%) of TA group and in 7 eyes (87.5%) of Non-TA group (p=0.04).

Conclusions: : The absorption of macular edema in TA group was worse than Non-TA group and visual acuity did not significantly improve in TA group. It may be suggested that RON with adjunctive intraocular TA for CRVO should be avoided.

Keywords: vitreoretinal surgery • drug toxicity/drug effects • retina