ObjectiveTo observe the clinical effect of radial optic neurotomy (RON) for central retinal vein occlusion (CRVO).MethodsThe clinical data of 5 patients with CRVO who had undergone RON after a standard three-port vitrectomy were analyzed retrospectively. In the 5 patents, CRVO was diagnosed in 2 before the surgery, and the examination of visual acuity, fundus photography, fundus fluorescein angiography (FFA), color doppler imaging (CDI), and examination of perimeter and optic coherence tomography (OCT) were performed on them before and after the operations, respectively. Three patients underwent the operation because of the vitreous hemorrhage and CRVO was diagnosed during the surgery. All of the 5 patients suffered from severe macular edema. The results of post-operative visual acuities, fundus examination, fundus photography and OCT were compared with those of the pre-operative ones. The follow-up after the surgery was 12 months. ResultsThe visual acuities improved in 4 patients and decreased in 1. The results of fundus photography and (or) FFA, and OCT revealed that the macular edema was evidently alleviated 1 month after the surgery and the retinal hemorrhage was absorbed ultimately 2 months after the surgery. The result of examination of perimeter performed on 1 case showed the improvement of visual field. In addition, vitreous hemorrhage occurred in 1 patient postoperatively and hemorrhage occurred in 2 in the operation puncturing the optic disk.ConclusionsRON is helpful to ameliorate the macular edema, reduce the retinal hemorrhages, prevent the neovascularization and enhance the visual acuity to some extent, which maybe clinically feasible and valuable in treating CRVO，but more prospective, randomized, and multi-center researches are still needed to verify the efficacy.(Chin J Ocul Fundus Dis, 2005,21:6-9)
Objective To observe the therapeutic effect of radial optic neurotomy (RON) for ischemic central retinal vein occlusion (CRVO) with macular edema. Methods The clinical data of 6 patients with ischemic CRVO combined with macular edema who had been treated with vitrectomy and radial optic neurotomy were retrospectively analyzed. The pre- and post-operative visual acuity, results of fundus fluorescein angiography (FFA) and optic coherence tomography (OCT), including the macular thickness, fluorescein filling in retinal veins, retinal hemorrhages and papilloedema were analyzed and compared. Results In the 6 patients, the visual acuity increased in different degrees and retinal hemorrhages decreased evidently. Macular edema was alleviative in 5 patients, retinal vein dilatation meliorated in 4, and papilloedema disappeared in 2. Conclusion RON may alleviate macular edema in patients with ischemic CRVO, but the relation of the therapeutic effect and vitrectomy can not be eliminated. (Chin J Ocul Fundus Dis, 2005,21:3-5)
ObjectiveTo observe the clinical therapeutic effects of radial optic neurotomy (RON) for central retinal vein occlusion (CRVO).MethodsThe clinical data of 12 patients (12 eyes) with CRVO who had undergone RON were retrospectively analyzed. The patients were examined by visual acuity and fundus examination, photography, fundus fluorescein angiography, and optical coherence tomography (OCT). The visual acuities of all of the 12 eyes with severe hemorrhage and retinal edema were less than 0.1. A microvitreoretinal blade or CRVO knife was penetrate into the nasal side of the optic disk, and the incision reached the cribriform plate and even the back, and then dissected at the nasal side of the cribriform plate. The postoperative follow-up period lasted 2 to 15 months with the mean of 6.5 months, and the visual acuity, the condition of visual field and ocular fundus of the eyes undergone the surgery were observed.ResultsIn 12 eyes undergone RON successfully, the visual acuity after the surgery improved more or less in 9 (75%), and more than or up to 0.1 in 6. The results of the examinations showed that the retinal edema and hemorrhage disappeared gradually, varicosity mitigated, retinal serous detachment mitigated or disappeared, and macular cystoid edema faded; macular fovea recovered in 3 eyes, optic nerve had a hemorrhage during the operation in 3 eyes, and the dissected part of optic nerve became atrophic afterward in 4.ConclusionsRON performed at the edge of the nasal side of the optic disc is safe and effective, which may improve the visual acuity of the eyes with CRVO and mitigate retinal hemorrhage and edema.(Chin J Ocul Fundus Dis, 2005,21:10-12)