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)
Objective lt;brgt;To evaluate the efficacy of arteriovenous sheathotomy on treatment of branch retinal vein occlusion (BRVO). lt;brgt; lt;brgt;Methods lt;brgt;Six consecutive patients (6 eyes) with BRVO underwent par plana vitrectomy, po lt;brgt;sterios vitreous cortex separation, arteriovenous sheathotomy for BRVO. The foll lt;brgt;owup period was within 3～12 months. Postoperative examinations included color fundus photography, fundus fluorescein angiography(FFA), optical coherence tomography(OCT) and multifocal electroretinography (mERG). lt;brgt; lt;brgt;Results lt;brgt;Increasing downstream blood flow in proximal past of compressed venule was promptly observed during the procedures of incision of the advential sheath of blood vessel, and separating and elevating the ateriole from the venule in all the operations in this series. Visual acuities improved postoperatively in 5 patients, and the best corrected visual acuity was 1.5. The examination of FFA showed obvious absorption of retinal hemorrhage, and leakage of dye was reduced, while large areas of capillary closure in retinas distal to the sheathotomy site were found 3 months after operation in 3 patients. OCT revealed disappearance or lightening of macular edema. mERG showed that the response amplitude of retina including the macular area was obviously higher after the operation. There was recurrent vitreous hemorrhage necessitating further surgery in one patient. lt;brgt; lt;brgt;Conclusion lt;brgt;The operation of arteriovenous sheathotomy for the treatment of BRVO is much beneficial to improve patient′s visual acuity, downstream blood flow and macular affections, although the improvement of retinal reperfusion of the retina is not obvious. lt;brgt; lt;brgt;(Chin J Ocul Fundus Dis,2002,18:6-9)
Objective To investigate the effects and complications of the vitrectomy for Eales′ disease with vitreous hemorrhage or traction retinal detachment. Methods Seventy-seven eyes of 69 cases undergoing vitrectomy for Eales′ disease with vitreous hemorrhage or traction retinal detachment were analyzed retrospectively. Results (1) The postoperative visual acuity was enhanced significantly. (2) Complications during the operation in 11 eyes (14.3%): iatrogenic retinal break in 7 eyes, bleeding in 3 eyes and lens damage in 1 eye. (3) Postoperative complications in 20 eyes (26.0%): rebleeding in 14 eyes, elevated IOP in 6 eyes, retinal detachment in 5 eyes, hyphema in 2 eyes, and exudative membrane in anterior chamber in 1 eye. (4) The main long-term complication was cataract formation (9 eyes) and macular disorder (6 eyes). Conclusion Vitrectomy is an effective method to treat Eales′ disease with vitreous hemorrhage or traction retinal detachment. (Chin J Ocul Fundus Dis, 2002, 18: 215-217)
Objective To investigate the method and effect of krypton laser photocoagulation for neovascularization in retinal vein occlusion . Methods Tweenty eight eyes of 27 patients with retinal vein occlusion with neovascularization were photocoagulated by krypton green and red laser.The fundus changes were observed by fundus fluorescein angiography after photocoagulation. Results The neov ascularization disappeared completely in 20 eyes and became smaller in 6 eyes,re mained no change in 2 eyes,and the visual acuity improved in 17 eyes (60.7%) after 6 monthes to 2.5 years of follow-up. Conclusion Krypton laser photocoagulation is obviously effective on regression of n eovascularization and prevenion of vitreous hemorrhage in retinal vein occlusion . (Chin J Ocul Fundus Dis, 2001,17:12-14)
Purpose To evaluate the therapeutic effect of laser-induced chorioretinal venous anastomosis for retinal vein occlusion (RVO)． Methods The investigation included 28 consecutive patients (28 eyes) with RVO．The non-ischemic group 18-cases (18 eyes) we re tre ated with the krypton red laser to induce chorioretinal venous anastomosis， the ischemic group underwent the same therapy and the grid or scattertype photoco agulation at the same time． All of the eyes were followed up for more than 5 mo nths， and with an average period of 6.6 months． Results Seven cases (7 eyes， 38．9%) of the non-ischemic group created successful chorioretinal venous anastomosis， with mean improvement of 4．43plusmn;0．7 8 standard deviation lines of best corrected visual acuity compared to0.19plusmn;0.67 lines for 11 eyes with unsuccessful anastomosis (Plt;0.001)．None of the seven eyes developed to ischemic state． Four of the 11 eyes with unsuccessful anastomosis converted to ischemic type (36.4%) ．Two cases of the ischemic group created successful anastomosis with improvement in visual acuity． The other cases had no change in visual acuity． Conclusion Laser-induced chorioretinal venous anasto mosis is a new therapeutic method for RVO， especially for nonischemic type and successful anastomosis can decrease the conversion rate of the vein occlusion to an ischemic state． (Chin J Ocul Fundus Dis, 2001,17:8-11)
Purpose To evaluate the efficacy of vitreous surgery and endolaser in a series of patients with retinal vein occlusion(RVO)with vitreous hemorrhage,neovascular membranes(NVM) and/or traction retinal detachment(TRD). Methods Clinical records were reviewed on 37 consecutive patients(38 eyes)who underwent vitreous surgery and endolaser for RVO with persistent vitreous hemorrhage,NVM and/or TRD.There were 19 patients(20 eyes)with retinal branch vein occlusion (BRVO)and 18 patients(18 eyes)with central retinal vein occlusion(CRVO). Results NVM and TRD were confirmed during operation in 27 and 23 eyes,respectively.Visual acuity improved postoperatively in 34 eyes(89.5%)including 22 eyes with 0.1 or better vision,and 4 eyes remained unchanged.CRVO group had longer history and less visual improvement after surgery. Conclusions Vitreous surgery and endolaser photocoagulation can improve the outcome in the majority of patients with RVO with vitreous hemorrage,NVM and/or TRD. (Chin J Ocul Fundus Dis,1998,14:3-6)