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M.D. Wolf, S.J. Sramek; Early Radial Optic Neurotomy for Central Retinal Vein Occlusion . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4030.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To compare the results of early (within 30 days of symptoms) vs late vitrectomy/radial optic neurotomy in patients with a central retinal vein occlusion. Methods:Vitrectomy and radial optic neurotomy was performed on 8 consecutive patients within 30 days of onset of symptoms and compared to 16 patients with surgery 1 to 10 months after onset. Measures included visual acuity, comparison of fundus photographs, fluorescein leakage, and retinal thickening by OCT. Minimum followup was 6 months. Results: Initial visual acuities were similar in both groups and ranged from 20/100–hand motions with no difference in Snellen average (20/300). In the early surgery group vision improved an average of 7 lines with a final average visual acuity of 20/40. In contrast in the late surgery group vision improved an average of 2 lines to 20/150. Simultaneous intravitreal triamcinolone acetate appeared to enhance the resolution of macular edema. OCT and fluorescein angiography improved in both groups, although eyes in the late group had residual macular pigmentary changes. Conclusions: The results in this small study suggest that the timing of vitrectomy/radial optic neurotomy may have an important influence on the visual outcome in patients with CRVO. No difference was found between the groups in anatomic outcome as measured by retinal edema. Permanent macular changes may limit improvement in visual acuity in long–standing CRVOs.
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