Radial optic neurotomy for the management of hemicentral retinal vein occlusion: long-term follow-up study.

Abstract

To assess the efficacy of radial optic neurotomy (RON) for hemicentral retinal vein occlusion (hemi-CRVO) in patients with follow-up of >12 months. Five consecutive patients with hemi-CRVO were enrolled in the study and underwent vitrectomy with RON. The effects of this treatment were assessed by visual acuity, optical coherence tomography, indocyanine green angiography, and kinetic visual field testing. The median and mean visual acuities improved from 20/250 to 20/50 and from 20/286 to 20/51, respectively. Four patients (80%) had visual acuity improvement of > or =3 lines; visual acuity in 1 patient (20%) remained the same. Visual acuity in all four eyes with preoperative visual acuity of <20/200 improved to >20/200 12 months after surgery. Foveal thickness was gradually reduced during the follow-up period. Chorioretinal anastomosis was detected by indocyanine green angiography in 3 eyes (60%). A temporal visual field defect was found in two eyes. No neovascularization on the iris, angle, optic disk, or retina was detected postoperatively. Visual acuity may improve more with RON compared with the natural history of the disease, and no neovascular formation may occur after RON, suggesting that this procedure may be an effective treatment for hemi-CRVO.