PURPOSE: To compare the surgical outcomes and evaluate the effectiveness of two treatments for central retinal vein occlusion: radial optic neurotomy (RON) and cannulation of tissue plasminogen activator (tPA) into the retinal vein (tPA). METHODS: This study consisted of 22 eyes. The inclusion criterion was a best-corrected visual acuity of < or =20/60 due to central retinal vein occlusion. The exclusion criteria were previous treatment and the presence of ocular neovascularization. Patients were randomized into RON or tPA groups (n = 11 each). Best-corrected visual acuity, macular thickness, and complications were recorded. RESULTS: The mean best-corrected visual acuity changed from 16/200 at baseline to 20/167 at 12 months in RON (P = 0.217) and from 10/200 to 20/200 in tPA (P = 0.051). The preoperative macular thicknesses decreased from 1,059 microm to 406 microm 12 months postoperatively in RON (P < 0.001) and from 1,121 microm to 271 microm (P < 0.001) in tPA. Neovascular glaucoma developed in 2 eyes (18%) in RON and in 4 eyes (40%) in tPA. Visual field defects associated with surgery were seen in 2 eyes (18%) in RON. CONCLUSION: There was no significant difference in surgical outcomes between the two procedures. Although best-corrected visual acuity and macular edema improved, the incidence of neovascular glaucoma was high. It is, therefore, still uncertain whether these treatments are effective.
RCT Entities:
PURPOSE: To compare the surgical outcomes and evaluate the effectiveness of two treatments for central retinal vein occlusion: radial optic neurotomy (RON) and cannulation of tissue plasminogen activator (tPA) into the retinal vein (tPA). METHODS: This study consisted of 22 eyes. The inclusion criterion was a best-corrected visual acuity of < or =20/60 due to central retinal vein occlusion. The exclusion criteria were previous treatment and the presence of ocular neovascularization. Patients were randomized into RON or tPA groups (n = 11 each). Best-corrected visual acuity, macular thickness, and complications were recorded. RESULTS: The mean best-corrected visual acuity changed from 16/200 at baseline to 20/167 at 12 months in RON (P = 0.217) and from 10/200 to 20/200 in tPA (P = 0.051). The preoperative macular thicknesses decreased from 1,059 microm to 406 microm 12 months postoperatively in RON (P < 0.001) and from 1,121 microm to 271 microm (P < 0.001) in tPA. Neovascular glaucoma developed in 2 eyes (18%) in RON and in 4 eyes (40%) in tPA. Visual field defects associated with surgery were seen in 2 eyes (18%) in RON. CONCLUSION: There was no significant difference in surgical outcomes between the two procedures. Although best-corrected visual acuity and macular edema improved, the incidence of neovascular glaucoma was high. It is, therefore, still uncertain whether these treatments are effective.
Authors: Brian C Becker; Sungwook Yang; Robert A Maclachlan; Cameron N Riviere Journal: Proc IEEE RAS EMBS Int Conf Biomed Robot Biomechatron Date: 2012-12-31
Authors: Marc D de Smet; Jean Marie Stassen; Thijs C M Meenink; Tom Janssens; Valérie Vanheukelom; Gerrit J L Naus; Maarten J Beelen; Bart Jonckx Journal: Br J Ophthalmol Date: 2016-09-28 Impact factor: 4.638