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C.S. Martinez-Jardon, J. Dalma-Weiszhausz, V. Morales-Canton, M. Garza-Leon, J.L. Guerrero-Naranjo; Radial Optic Neurotomy for Ischemic Central Vein Occlusion . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4053.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the efficacy of Radial Optic Neurotomy (RON) in eyes with ischemic central retinal vein occlusion (CRVO). Methods: A prospective, longitudinal, descriptive and experimental study was conducted including ten consecutive patients of both genders with ischemic CRVO (afferent pupillary defect, edematous optic disc and markedly decreased visual acuity) After signing an informed consent, radial optic neurotomy (RON) was performed in ten patients with ischemic CRVO with visual acuity ranging from 20/300 to hand motion (HM). Prior pars plana vitrectomy, a microvitreoretinal blade was used to incise the scleral ring, cribriform plate and adjacent sclera at the nasal edge of the optic disc (as described by Opremack). We evaluated changes in best corrected visual acuity (BCVA), intraocular pressure (IOP), color fundus photos, fluorescein angiography, multifocal electroretinography (mERG), optic coherence tomography (OCT) as well as complications at 1, 3 and 6 months after the procedure. Results: Ten phakic eyes of ten patients were included. RON was performed in all eyes. Patient's ages ranged between 54 and 78 years (mean 69.66). Two patients improved from HM to 20/300, three from 20/300 to 20/200, and five showed no improvement of visual acuity. Preoperative IOP pressure was between 12 to 21mmHg (mean 16.33) and postoperative IOP ranged from 8 to 12 mmHg (mean 11). Color fundus photos, fluorescein angiography and mERG showed no improvement after the surgery. Preoperatively macular thickness measured by OCT ranged between 611 to 900 µ (mean 786); and between 283 to 700 µ (mean 559.75) three months after the procedure with no correlation in the visual acuity improvement. We had one patient who suffered a central artery perforation during the procedure and two with intraoperative bleeding during the RON that resolved by raising the intraocular pressure. Conclusions: Our results suggest that eyes with ischemic CRVO that underwent RON showed no benefit in macular thickness, macular function or visual acuity.
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