Mao-Nian Zhang1, Tie-Cheng Liu. 1. Department of Ophthalmology, The General Hospital of PLA, Beijing 100853, China. zhangmaonian@msn.com
Abstract
OBJECTIVE: To investigate the surgical effect and complication of optic neurotomy for ischemic central retinal vein occlusion (CRVO). METHODS: Eight patients elected to undergo optic neurotomy, The age range was 32 - 67 years, Five of the 8 were women and three were men. The duration of the CRVO were 3 - 8 months. Systemic hypertension was present in 3 patients and severe cystoid macular edema was present in 3 patient. No diabetes mellitus was noted in all 8 patients. A standard three-port vitrectomy was performed on 8 patients with severe ischemic CRVO, A microvitreoretinal (MVR) blade was used to relax the scleral ring and adjacent sclera of the optic disk, The depth of the incision into the optic nerve placed the MVR blade just beyond the widest portion of the diamond-shaped tip. The depth of the incision was 2.2 mm approximately. RESULTS: Optic neurotomy was performed in all 8 patients successfully, The small hemorrhage was noted during the surgical procedure in 2 patients limited to the incision site. The follow-up was 3 - 5 months range, All patients had improvement in the retina and macular edema and the appearance of the fundus as documented by photography, fluorescein angiography. And optic coherence tomography (OCT). Postoperative visual acuities were improved in 62.5% of patients and the visual acuities no changes were in 2 patients. Postoperative neovascular glaucoma was in 1 patient and vitreous hemorrhage in 2 patients. CONCLUSIONS: Optic neurotomy may improve the intraretinal hemorrhage, macular edema and the visual acuity prognosis in patients with ischemic CRVO.
OBJECTIVE: To investigate the surgical effect and complication of optic neurotomy for ischemic central retinal vein occlusion (CRVO). METHODS: Eight patients elected to undergo optic neurotomy, The age range was 32 - 67 years, Five of the 8 were women and three were men. The duration of the CRVO were 3 - 8 months. Systemic hypertension was present in 3 patients and severe cystoid macular edema was present in 3 patient. No diabetes mellitus was noted in all 8 patients. A standard three-port vitrectomy was performed on 8 patients with severe ischemic CRVO, A microvitreoretinal (MVR) blade was used to relax the scleral ring and adjacent sclera of the optic disk, The depth of the incision into the optic nerve placed the MVR blade just beyond the widest portion of the diamond-shaped tip. The depth of the incision was 2.2 mm approximately. RESULTS:Optic neurotomy was performed in all 8 patients successfully, The small hemorrhage was noted during the surgical procedure in 2 patients limited to the incision site. The follow-up was 3 - 5 months range, All patients had improvement in the retina and macular edema and the appearance of the fundus as documented by photography, fluorescein angiography. And optic coherence tomography (OCT). Postoperative visual acuities were improved in 62.5% of patients and the visual acuities no changes were in 2 patients. Postoperative neovascular glaucoma was in 1 patient and vitreous hemorrhage in 2 patients. CONCLUSIONS:Optic neurotomy may improve the intraretinal hemorrhage, macular edema and the visual acuity prognosis in patients with ischemic CRVO.