Korean J Ophthalmol.  2005 Dec;19(4):269-274. 10.3341/kjo.2005.19.4.269.

Comparative Evaluation of Radial Optic Neurotomy and Panretinal Photocoagulation in the Management of Central Retinal Vein Occlusion

• Kim TW
• Lee SJ
• Kim SD

• KMID: 754438
• DOI: http://doi.org/10.3341/kjo.2005.19.4.269

Abstract

PURPOSE
There is currently no treatment proven effective for central retinal vein occlusion (CRVO). Radial optic neurotomy (RON) has recently surfaced as a new treatment for the disorder, however, and we compare here the visual acuity (VA) and arteriovenous transit time (AVTT) following RON and panretinal photocoagulation (PRP). METHODS: We conducted a retrospective, uncontrolled study of 27 patients. Of 27 eyes diagnosed with CRVO, 16 were treated with panretinal photocoagulation (PRP) and 11 with RON. VA and fluorescein angiography were used to monitor the evolution of CRVO, and for follow-up. RESULTS: All patients underwent PRP or RON with no major complications. The difference between pre- and post-operative VA was not statistically significant for either group (p=0.092 on PRP; p=.0081 on RON). The change in AVTT was also not statistically significant for either group (p=0.024 on PRP; p=0.027 on RON). Ultimately, we found no statistically-significant difference in comparing VA and AVTT for the two groups (p=0.074 on VA; p=0.510 on AVTT). CONCLUSIONS: No evidence supporting the effectiveness of RON could be found in this study, suggesting that surgical decompression by RON may not be effective for treating CRVO. Further studies regarding the efficacy of RON should be made.

Keyword

Central retinal vein occlusion; Panretinal photocoagulation; Radial optic neurotomy; Surgical decompression

MeSH Terms

Visual Acuity
Treatment Outcome
Retrospective Studies
Retinal Vein Occlusion/pathology/physiopathology/*surgery
Retina/*surgery
Optic Nerve/*surgery
Middle Aged
Male
Laser Coagulation/*methods
Humans
Follow-Up Studies
Female
Decompression, Surgical/*methods
Aged
Adult

Figure

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  Fig. 1 The correlation between the preoperative and postoperative visual acuity in each group: A (PRP group, r=.435, p=.092*), B (RON group, r=.806, p=.081*). *Statistics by Spearman rank correlation analysis.

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  Fig. 2 The correlation between the preoperative and postoperative arteriovenous transit time in each group: A (PRP group, r=.786, p=.024*), B (RON group, r=.694, p=.027*). *Statistics by Spearman rank correlation analysis.

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  Fig. 3 In each group, visual acuity was negatively correlated with the arterioveouns transit time. A (PRP group, r=-0.656, p=.005*). B (RON group. r=-0.869, p=.001*). *Statistics by Spearman rank correlation analysis.

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  Fig. 4 The preoperative (A) and postoperative (B) visual fields of the patient 7. The wedge-shaped defect and this finding was correlated with the incision site in the radial optic neurotomy

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