M Rauber1, S Müller, U Mester. 1. Augenklinik, Bundesknappschaft Sulzbach, An der Klinik 10, 66280 Sulzbach (Saar), Germany. RauberMartin@gmx.de
Abstract
BACKGROUND: Retinal central venous outflow pressure (VOP) can be measured with a new ophthalmodynamometer (Meditron, Völklingen, Germany). Radial optic neurotomy (RON) is a new surgical approach for central retinal vein occlusion (CRVO) which is still controversially discussed. Particularly the early formation of retinochoroidal collaterals is intended to achieve normalization of the preoperatively increased pressure in the central retinal vein. We investigated the VOP after RON. PATIENTS AND METHODS: In total, 21 eyes of 21 patients (9 male, 12 female) suffering from CRVO were treated by RON. Pars plana vitrectomy with nasal radial optic neurotomy and peeling of the internal limiting membrane were performed. The mean follow-up time was 10.8 months (6-24 months). Central venous outflow pressure was measured using ophthalmodynamometry. RESULTS: The most frequent concomitant ophthalmic disease was glaucoma (52%), and the predominantly associated systemic disease was hypertension (81%). After RON in 16 eyes (76%) visual acuity improved by at least 2 lines; in 3 eyes (14%) visual acuity was unchanged (+/-1 line) and in 2 patients (10%) visual acuity decreased by 2 or more lines. Eyes with visual improvement and formation of chorioretinal anastomosis postoperatively showed a significantly lower venous outflow pressure assessed with ophthalmodynamometry.
BACKGROUND: Retinal central venous outflow pressure (VOP) can be measured with a new ophthalmodynamometer (Meditron, Völklingen, Germany). Radial optic neurotomy (RON) is a new surgical approach for central retinal vein occlusion (CRVO) which is still controversially discussed. Particularly the early formation of retinochoroidal collaterals is intended to achieve normalization of the preoperatively increased pressure in the central retinal vein. We investigated the VOP after RON. PATIENTS AND METHODS: In total, 21 eyes of 21 patients (9 male, 12 female) suffering from CRVO were treated by RON. Pars plana vitrectomy with nasal radial optic neurotomy and peeling of the internal limiting membrane were performed. The mean follow-up time was 10.8 months (6-24 months). Central venous outflow pressure was measured using ophthalmodynamometry. RESULTS: The most frequent concomitant ophthalmic disease was glaucoma (52%), and the predominantly associated systemic disease was hypertension (81%). After RON in 16 eyes (76%) visual acuity improved by at least 2 lines; in 3 eyes (14%) visual acuity was unchanged (+/-1 line) and in 2 patients (10%) visual acuity decreased by 2 or more lines. Eyes with visual improvement and formation of chorioretinal anastomosis postoperatively showed a significantly lower venous outflow pressure assessed with ophthalmodynamometry.
Authors: H J Zambarakji; S Ghazi-Nouri; M Schadt; C Bunce; P G Hykin; D G Charteris Journal: Graefes Arch Clin Exp Ophthalmol Date: 2004-11-17 Impact factor: 3.117