Prospective Evaluation of Radial Optic Neurotomy in Ischemic Central Retinal Vein Occlusion

Tewari HK, Pillai GS, Sony P, Venkatesh P, Garg SP
Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

Background:

To evaluate the safety and efficacy of radial optic neurotomy in eyes with ischemic central retinal vein occlusion (CRVO).

Methods:

Seven eyes of 7 patients with ischemic CRVO were included in this prospective nonrandomized interventional case series. All eyes underwent radial optic neurotomy. A record of best-corrected visual acuity (BCVA), intraocular pressure (IOP), iris neovascularisation (NVI), perfusion status on fundus fluorescein angiography (FFA) and macular thickness evaluation with optical coherence tomography (OCT) were used to monitor the effect of surgery.

Result:

Mean duration of vision loss was 1.9±1.2 months. Mean post-operative follow -up was 8.3 ±3.8 months. Five eyes (71.4%) showed an improvement in visualacuity; 3 (43%) eyes achieved a visual acuity of 20/200 or better. Decrease in macular thickness and disc edema was observed on OCT. No change in the perfusion status was noted on FFA following surgery. One eye developed vitreous hemorrhage and neovascular glaucoma.

Conclusion:

Radial optic neurotomy may decrease macular edema and improve visual acuity in eyes with ischemic CRVO. Larger case-controlled studies are required to establish its role in management of ischemic CRVO.