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      Radial Optic Neurotomy for Central Retinal Vein Occlusion: Long-Term Retinal Perfusion Outcome

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          Abstract

          Background/Aims:To analyze the long-term changes in retinal perfusion and functional improvement induced by radial optic neurotomy (RON) in central retinal vein occlusion (CRVO). Methods: Sixty-three eyes of 63 consecutive patients with CRVO were included. Twenty-eight (44.5%) patients underwent RON and 35 (55.5%) were followed as a control group. Time of arteriovenous transit and visual acuity were determined at baseline and after 1-year follow-up. Results:After 1 year, retinal perfusion status improved in 63.1% of operated eyes and 14.3% of controls (p = 0.048). The improvement in arteriovenous retinal transit was statistically significant (p = 0.023) only in the RON group. The visual improvement in the RON group was significantly better (p = 0.043) than in the control group. Moreover, the development of chorioretinal anastomosis was significantly higher (p = 0.036) after RON than in controls and correlated with better functional results. In operated eyes there was a lower incidence of CRVO-related complications. Conclusion:RON improved retinal perfusion and achieved a better functional outcome. The measurement of perfusion changes as presented here may be useful for monitoring CRVO and assessing other treatment modalities.

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          Intravitreal Avastin for macular oedema secondary to retinal vein occlusion: a prospective study.

          Marjorie Funk, K Kriechbaum, W Geitzenauer … (2008)
          To evaluate efficacy and safety of intravitreal bevacizumab (Avastin) in eyes with macular oedema secondary to central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO). Twenty-eight consecutive patients (28 patients, 29 eyes, 8 CRVO, 21 BRVO) were enrolled in the study. Three intravitreal injections of 1 mg bevacizumab (0.04 ml) were administered at 4-week intervals; further retreatment was based on optical coherence tomography (OCT) findings. Follow-up examinations were done at days 1, 7 and 28 and at monthly intervals thereafter. Mean baseline central retinal thickness (CRT) in OCT was 558 microm (range 353-928 microm) and mean BCVA was 20/100. One day after the first injection, CRT significantly decreased to 401 microm (p<0.01). Three injections reduced macular oedema to 328 microm CRT (p<0.01) and improved BCVA to 20/50 (p<0.01). At 6 months, CRT was 382 microm (p<0.01), and BCVA was stable at 20/50(-2) (p<0.01), FA showed no evidence of increased avascular zones. Intravitreal injections of bevacizumab appear to be a safe and effective therapy in the treatment of macular oedema secondary to retinal vein occlusion.
          Article 0 comments Cited 35 times – based on 0 reviews     Review now
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            Intravitreal triamcinolone acetonide for macular oedema due to central retinal vein occlusion.

            Jay Duker, Adam Martidis, Harry Greenberg … (2002)
            Article 0 comments Cited 30 times – based on 0 reviews     Review now
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              Early bevacizumab treatment of central retinal vein occlusion.

              Daniela Ferrara, Hideki Koizumi, Richard Spaide (2007)
              To evaluate the change in visual acuity and retinal appearance in patients after early initiation of intravitreal bevacizumab treatment for central retinal vein occlusion (CRVO). Retrospective, interventional case series. Patients with CRVO of fewer than three months' duration receiving intravitreal bevacizumab as primary treatment were evaluated. Patients received an intravitreal 1.25 mg (0.05 ml) bevacizumab injection. Changes in visual acuity, central macular thickness, venous tortuosity and diameter, and optic disk edema were noted. Six eyes of five consecutive patients with CRVO treated with intravitreal bevacizumab injection were reviewed retrospectively. The patients did not have other ocular conditions that could have compromised visual acuity. The mean baseline visual acuity was 20/428 (logarithm of the minimum angle of resolution [logMAR] units, 1.33). The mean follow-up period was 12 months (range, seven to 15 months), and the number of bevacizumab injections ranged from four to 10. The patients showed a statistically significant decrease in optic nerve head swelling, venous tortuosity, and venous diameter, with the largest proportion of change occurring within one month of the first bevacizumab injection. The mean visual acuity at last follow-up was 20/53 (logMAR units, 0.42; P = .035, as compared with baseline). In no patient did collateral vessels at the optic nerve head develop. The patients experienced a dramatic improvement in the visual acuity and clinical fundus appearance, without collateral vessel formation. These findings are difficult to explain with current theories of the pathophysiologic features of CRVO. These findings also suggest early initiation of anti-vascular endothelial growth factor (VEGF) treatment should be studied in a larger trial for CRVO.
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                Author and article information

                Journal
                Journal ID (publisher-id): OPH
                Journal ID (nlm-ta): Ophthalmologica
                Journal ID (doi): 10.1159/issn.0030-3755
                Title: Ophthalmologica
                Publisher: S. Karger AG
                ISSN (Print): 0030-3755
                ISSN (Electronic): 1423-0267
                Publication date Subscription-year: 2009
                Publication date (Print): August 2009
                Publication date (Electronic): 07 May 2009
                Volume: 223
                Issue: 5
                Pages: 313-319
                Affiliations
                aDepartment of Ophthalmology, Philipps University Marburg, Marburg, bDepartment of Ophthalmology, Albert Ludwigs University, Freiburg, cDepartment of Ophthalmology, University of Bonn, Bonn, Germany
                Article
                Publisher ID: 217730 Other ID: Ophthalmologica 2009;223:313–319
                DOI: 10.1159/000217730
                PubMed ID: 19420979
                SO-VID: cf666f39-0cee-4d92-9bd3-b847ef8c1e63
                Copyright © © 2009 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 02 July 2008
                Date accepted : 22 August 2008
                Page count
                Figures: 4, Tables: 4, References: 27, Pages: 7
                Categories
                Subject: Original Paper

                ScienceOpen disciplines: Vision sciences,Ophthalmology & Optometry,Pathology
                Keywords: Retinal perfusion,Radial optic neurotomy,Central retinal vein occlusion
                Data availability:
                ScienceOpen disciplines: Vision sciences, Ophthalmology & Optometry, Pathology
                Keywords: Retinal perfusion, Radial optic neurotomy, Central retinal vein occlusion

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