Long-term follow-up of a modified technique for laser-induced chorioretinal venous anastomosis in nonischemic central retinal vein occlusion.

Abstract

To evaluate the long-term outcomes of a modified technique for laser chorioretinal venous anastomosis in nonischemic central vein occlusion (CVO). Prospective, noncomparative, consecutive case series. Nineteen eyes of 19 patients. Nineteen consecutive eyes with nonischemic CVO were observed for a mean period of 48 months after attempted laser-induced chorioretinal venous anastomosis therapy using a technique modified intentionally to avoid vein wall rupture. Anastomosis patency, visual acuity, maintenance of nonischemic status, and complications were measured. At least one patent anastomosis developed eventually in 19 of 19 eyes (100%). Two anastomoses developed in 5 of 19 eyes (26%). There were one or two nonfunctioning sites in 8 of 19 eyes (42%). The maximum number of treatment attempts in a single eye was four. Snellen visual acuity was unchanged in 3 of 19 eyes (16%) and improved from 1 to 11 lines (mean improvement, 5 lines) in 16 of 19 eyes (84%) during the mean follow-up period of 48 months. Nineteen of 19 eyes (100%) maintained nonischemic status. Treatment complications were limited to localized preretinal fibrosis. Rupture of the vein wall is not required to form a functioning laser-induced chorioretinal venous anastomosis in eyes with nonischemic CVO. A technique modified intentionally to avoid vein wall rupture seems to be safer and more predicable.