Retinal Collateral Veins After Radial Optic Neurotomy for Central Retinal Vein Occlusion

Abstract

Abstract: : Purpose: To evaluate the role of retinal collateral vein formation on the optic nerve head after radial optic neurotomy (RON) for central retinal vein occlusion (CRVO). Methods: Retrospective medical record review of 20 eyes that underwent pars plana vitrectomy with RON for CRVO from October 31, 2001 to October 11, 2002 was performed. Duration of CRVO, pre– and postoperative best corrected visual acuity (BCVA), presence of collateral vessels, neovascularization, and other relevant clinical findings were examined. Data was extracted and compiled on a Microsoft Excel spreadsheet for statistical analysis. Results: Sixty percent of eyes developed collateral veins following RON. Of the eyes with collateral vessel formation, 42% had a mean final BCVA of >20/100 compared to 12% without collateral veins. Twenty–five percent of eyes with collateral veins had a mean final BCVA of <20/400, while 88% of eyes without collateral veins had a mean final BCVA of <20/400. There was a mean 2 lines of visual acuity improvement in the eyes with post–RON collateral vein development, and a mean –1 line of visual acuity loss in the eyes without collateral vein formation after RON. Conclusions: The presence of retinal collateral veins on the optic nerve head following RON for CRVO is a prognostic indicator for visual outcome.

Keywords: vascular occlusion/vascular occlusive disease • vitreoretinal surgery • retina