EFFECTIVENESS OF RADIAL OPTIC NEUROTOMY FOR ISCHEMIC CENTRAL RETINAL VEIN OCCLUSION

Abstract

Objective: To determine the effectiveness of radial optic neurotomy as a treat- ment modality for ischemic central retinal vein occlusion.

Methodology: This was an interventional study of 15 patients with ischemic central retinal vein occlusion (CRVO) who had severe loss of visual acuity. The study was carried out prospectively from July 2015 to June 2017. These patients underwent radial optic neurotomy (RON) within six months of disease onset. Patients were followed postoperatively with standard ocular examination in- cluding visual acuity and fundus examinations after 07, 30 and 90 days. Analysis of data was carried out using SPSS version 22.

Results: Our findings showed that best-corrected visual acuity before surgery ranged from hand movements(HM) to 6/60 or 2.10-1.00 log MAR (mean 1.72 log MAR). Pre-operatively 6 (40%) patients had visual acuity of HM, 4 (26.7%) had 1/60, 2 (13.3%) had 3/60 and 3(20%) patients had a visual acuity of 6/60. On the last post operative follow up at three months, 2 (13.3%) patients had a visual acuity of HM, 6 (40%) had 6/60, 4 (26.7%) had 6/36 and 3(20%) had 6/24. At 03 months, one patient's (6.66%) had deterioration of vision whereas one patient's (6.66%) visual acuity remained unchanged and 13 (86.66%) patient's had some improvement in vision. One patient had intra operative bleeding due to injury to the central retinal artery caused by micro-vitreoretinal (MVR) blade.

Conclusion: Radial optic neurotomy improved both the visual function and macular edema in ischemic central retinal vein occlusion.