Skip to main content

Advertisement

SpringerLink
Log in

Long-term effects of radial optic neurotomy for central retinal vein occlusion consecutive interventional case series

  • Clinical Investigation
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the long-term (minimum 24 months follow-up) clinical results of radial optic neurotomy (RON) following a pars plana vitrectomy (PPV) with internal limiting membrane peeling as treatment for central retinal vein occlusion (CRVO).

Methods

Interventional case series of 14 consecutive patients (14 eyes) with CRVO who were treated with a PPV combined with RON within 1 year of diagnosis.

Results

Median baseline visual acuity (VA) was 1.05 logMAR (≈0.09 Snellen) in the affected eye. The follow-up period ranged from 24 to 48 months postoperatively, median 30 months. At the 24-month follow-up examination, median VA was 1.005 logMAR in the affected eye-a significant improvement (p = 0.013). Six patients (43%) gained 1 or more lines of VA (mean VA gain = 1.7 lines), while the VA of four patients (29%) improved by 3 or more lines. The eyes with nonischemic CRVO demonstrated a significantly higher improvement in VA (p = 0.0007) than the eyes with ischemic CRVO.

Conclusion

With RON clinically relevant improvements on a long-term basis seem achievable. Patients with nonischemic CRVO may respond more favorably than patients with ischemic CRVO.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. The Central Vein Occlusion Study Group (1997) Natural history and clinical management of central retinal vein occlusion. Arch Ophthalmol 115:486–491

    Google Scholar 

  2. Gutman FA (1983) Evaluation of a patient with central retinal vein occlusion. Ophthalmology 90:481–483

    PubMed  CAS  Google Scholar 

  3. Guven D, Sayinalp N, Kalayci D, Dundar S, Hasiripi H (1999) Risk factors in central retinal vein occlusion and activated protein C resistance. Eur J Ophthalmol 9:43–48

    PubMed  CAS  Google Scholar 

  4. Aggermann T, Brunner S, Binder S (2003) Therapien retinaler Venenverschlüsse-ein Überblick. Spektrum der Augenheilkunde 17:200–205

    Google Scholar 

  5. Cooney MJ, Fekrat S, Finkelstein D (1998) Current concepts in the management of central retinal vein occlusion. Curr Opin Ophthalmol 9:47–50

    Article  PubMed  CAS  Google Scholar 

  6. Central vein occlusion study group (1995) Evaluation of grid pattern photocoagulation for macular edema in central vein occlusion. The Central Vein Occlusion Study Group M report Ophthalmology 102:1425–1433

    Google Scholar 

  7. Green WR, Chan CC, Hutchins GM, Terry JM (1981) Central retinal vein occlusion: a prospective histopathologic study of 29 eyes in 28 cases. Trans Am Ophthalmol Soc 79:371–422

    PubMed  CAS  Google Scholar 

  8. Opremcak EM, Bruce RA, Lomeo MD, Ridenour CD, Letson AD, Rehmar AJ (2001) Radial optic neurotomy for central retinal vein occlusion: a retrospective pilot study of 11 consecutive cases. Retina 21:408–415

    Article  PubMed  CAS  Google Scholar 

  9. Binder S, Brunner S, Abri A, Glittenberg C (2003) Radiäre Neurotomie des Nervus Opticus-Erste Ergebnisse. Spektrum Augenheilkd 17:206–211

    Article  Google Scholar 

  10. Holladay JT (1997) Proper method for calculating average VA. J Refract Surg 13:388–391

    PubMed  CAS  Google Scholar 

  11. Hayreh SS (2003) Management of central retinal vein occlusion. Ophthalmologica 217:167–188

    Article  PubMed  Google Scholar 

  12. Central Vein Occlusion Study Group (1993) Baseline and early natural history report. Arch ophthalmology 111:1087–1095

    Google Scholar 

  13. Magargal LE, Donoso LA, Sanborn GE (1982) Retinal ischemia and risk of neovascularisation following central retinal vein obstruction. Ophthalmology 89:1241–1245

    PubMed  CAS  Google Scholar 

  14. Binder S, Krebs I, Hilgers RD, Abri A, Stolba U, Assadoulina A, Kellner L, Stanzel BV, Jahn C, Feichtinger H (2004) Outcome of transplantation of autologous retinal pigment epithelium in age-related macular degeneration: a prospective trial. Invest Ophthalmol Vis Sci 45:4151–4160

    Article  PubMed  Google Scholar 

  15. Nomoto H, Shiraga F, Yamaji H, Kageyama M, Takenaka H, Baba T, Tsuchida Y (2004) Evaluation of radial optic neurotomy for central retinal vein occlusion by indocyanine green videoangiography and image analysis. Am J Ophthalmol 138:612–619

    Article  PubMed  Google Scholar 

  16. Weizer JS, Stinnett SS, Fekrat S (2003) Radial optic neurotomy as treatment for central retinal vein occlusion. Am J Ophthalmol 136:814–819

    Article  PubMed  Google Scholar 

  17. Garciia-Arumii J, Boixadera A, Martinez-Castillo V, Castillo R, Dou A, Corcostegui B (2003) Chorioretinal anastomosis after radial optic neurotomy for central retinal vein occlusion. Arch Ophthalmol 121:1385–1391

    Article  PubMed  Google Scholar 

  18. Williamson TH, Poon W, Whitefield L, Strothidis N, Jaycock P, Strothoudis N (2003) A pilot study of pars plana vitrectomy, intraocular gas, and radial neurotomy in ischaemic central retinal vein occlusion. Br J Ophthalmol 87:1126–1129

    Article  PubMed  CAS  Google Scholar 

  19. Friedman SM (2003) Optociliary venous anastomosis after radial optic neurotomy for central retinal vein occlusion. Ophthalmic Surg Lasers Imaging 34:315–317

    PubMed  Google Scholar 

  20. Hayreh SS (1994) Retinal vein occlusion. Indian J Ophthalmol 42:109–132

    PubMed  CAS  Google Scholar 

  21. McAllister IL, Douglas JP, Constable IJ, Yu DY (1998) Laser-induced chorioretinal venous anastomosis for nonischemic central retinal vein occlusion: evaluation of the complications and their risk factors. Am J Ophthalmol 126:219–229

    Article  PubMed  CAS  Google Scholar 

  22. Ip M, Kahana A, Altaweel M (2003) Treatment of central retinal vein occlusion with triamcinolone acetonide: an optical coherence tomography study. Semin Ophthalmol 18:67–73

    Article  PubMed  Google Scholar 

  23. Park CH, Jaffe GJ, Fekrat S (2003) Intravitreal triamcinolone acetonide in eyes with cystoid macular edema associated with central retinal vein occlusion. Am J Ophthalmol 136:419–425

    Article  PubMed  CAS  Google Scholar 

  24. Jonas JB, Kreissig I, Degenring RF (2002) Intravitreal triamcinolone acetonide as treatment of macular edema in central retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 240:782–783

    Article  PubMed  Google Scholar 

  25. Degenring RF, Kamppeter B, Kreissig I, Jonas JB (2003) Morphological and functional changes after intravitreal triamcinolone acetonide for retinal vein occlusion. Acta Ophthalmol Scand 81:548–550

    Article  PubMed  Google Scholar 

  26. Martidis A, Duker JS, Greenberg PB, Rogers AH, Puliafito CA, Reichel E, Baumal C (2002) Intravitreal triamcinolone for refractory diabetic macular edema. Ophthalmology 109:920–927

    Article  PubMed  Google Scholar 

  27. Moshfeghi DM, Kaiser PK, Scott IU, Sears JE, Benz M, Sinesterra JP, Kaiser RS, Bakri SJ, Maturi RK, Belmont J, Beer PM, Murray TG, Quiroz-Mercado H, Mieler WF (2003) Acute endophthalmitis following intravitreal triamcinolone acetonide injection. Am J Ophthalmol 136:791–796

    Article  PubMed  CAS  Google Scholar 

  28. Krepler K, Ergun E, Sacu S, Richter-Muksch S, Wagner J, Stur M, Wedrich A (2005) Intravitreal triamcinolone acetonide in patients with macular oedema due to central retinal vein occlusion. Acta Ophthalmol Scand 83:71–75

    Article  PubMed  CAS  Google Scholar 

  29. Wingate RJ, Beaumont PE, Aust NZ (1999) Intravitreal triamcinolone and elevated intraocular pressure. J Ophthalmol 27:431–432

    CAS  Google Scholar 

  30. Bakri SJ, Beer PM (2003) The effect of intravitreal triamcinolone acetonide on intraocular pressure. Ophthalmic Surg Lasers Imaging 34:386–390

    PubMed  Google Scholar 

  31. Jonas JB, Kreissig I, Degenring R (2003) Intraocular pressure after intravitreal injection of triamcinolone acetonide. Br J Ophthalmol 87:24–27

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, The Ludwig Boltzmann Institut for Retinology and Biomicroscopic Laser Surgery, Rudolf Foundation Clinic, Vienna, Austria

    Susanne Binder, Tina Aggermann & Simon Brunner

Authors
  1. Susanne Binder
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tina Aggermann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Simon Brunner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Susanne Binder.

Additional information

The authors have no commercial connection or financial interest that is related to the manuscript.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Binder, S., Aggermann, T. & Brunner, S. Long-term effects of radial optic neurotomy for central retinal vein occlusion consecutive interventional case series. Graefes Arch Clin Exp Ophthalmol 245, 1447–1452 (2007). https://doi.org/10.1007/s00417-007-0565-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-007-0565-x

Keywords

Search

Navigation