PURPOSE: Evaluate the effects of hemodilution in the treatment of central retinal vein occlusion (CRVO). PATIENTS AND METHODS: We carried out a retrospective, noncomparative study of 25 patients presenting unilateral CRVO, treated with one to three hemodilution sessions. The patients were re-examined in the 1st, 2nd, 3rd, 6th and 12th months following treatment with measurement of visual acuity, fluorescein angiography, and optical coherence tomography. RESULTS: Our study included 17 men and eight women, averaging 63 years of age (range, 35-87 years), and monitored for an average of 7 months (range, 3-12 months). After the 6th month following treatment, average visual acuity improved compared to initial visual acuity. Initial visual acuity of less than 1/10, with the existence of poorly irrigated areas in the angiography, presented negative prognosis factors. The number of hemodilutions did not produce a significant difference in final visual acuity. No serious complications due to hemodilution were observed. DISCUSSION: Treatment of CRVO is subject to debate. Some practitioners recommend against treatment, while others advocate intervention and offer laser-induced chorioretinal venous anastomosis. Surgical vitrectomy and radial optical neurotomy, with or without injection of triamcinolone, await evaluation. Hemodilution may offer a therapeutic approach to this pathology, in which the etiopathogenesis is not yet recognized, but in which blood viscosity plays a key role. This treatment is well tolerated. CONCLUSION: Hemodilutions appear to have beneficial effects in treating CRVO, whatever the number of hemodilutions used. This study should be confirmed by a prospective study using an untreated control group.
PURPOSE: Evaluate the effects of hemodilution in the treatment of central retinal vein occlusion (CRVO). PATIENTS AND METHODS: We carried out a retrospective, noncomparative study of 25 patients presenting unilateral CRVO, treated with one to three hemodilution sessions. The patients were re-examined in the 1st, 2nd, 3rd, 6th and 12th months following treatment with measurement of visual acuity, fluorescein angiography, and optical coherence tomography. RESULTS: Our study included 17 men and eight women, averaging 63 years of age (range, 35-87 years), and monitored for an average of 7 months (range, 3-12 months). After the 6th month following treatment, average visual acuity improved compared to initial visual acuity. Initial visual acuity of less than 1/10, with the existence of poorly irrigated areas in the angiography, presented negative prognosis factors. The number of hemodilutions did not produce a significant difference in final visual acuity. No serious complications due to hemodilution were observed. DISCUSSION: Treatment of CRVO is subject to debate. Some practitioners recommend against treatment, while others advocate intervention and offer laser-induced chorioretinal venous anastomosis. Surgical vitrectomy and radial optical neurotomy, with or without injection of triamcinolone, await evaluation. Hemodilution may offer a therapeutic approach to this pathology, in which the etiopathogenesis is not yet recognized, but in which blood viscosity plays a key role. This treatment is well tolerated. CONCLUSION: Hemodilutions appear to have beneficial effects in treating CRVO, whatever the number of hemodilutions used. This study should be confirmed by a prospective study using an untreated control group.