Long-term effects of radial optic neurotomy for central retinal vein occlusion consecutive interventional case series

PURPOSE: To investigate the long-term (minimum 24 months follow-up) clinical results of radial optic neurotomy (RON) following a pars plana vitrectomy (PPV) with internal limiting membrane peeling as treatment for central retinal vein occlusion (CRVO).

METHODS: Interventional case series of 14 consecutive patients (14 eyes) with CRVO who were treated with a PPV combined with RON within 1 year of diagnosis.

RESULTS: Median baseline visual acuity (VA) was 1.05 logMAR (approximately 0.09 Snellen) in the affected eye. The follow-up period ranged from 24 to 48 months postoperatively, median 30 months. At the 24-month follow-up examination, median VA was 1.005 logMAR in the affected eye-a significant improvement (p = 0.013). Six patients (43%) gained 1 or more lines of VA (mean VA gain = 1.7 lines), while the VA of four patients (29%) improved by 3 or more lines. The eyes with nonischemic CRVO demonstrated a significantly higher improvement in VA (p = 0.0007) than the eyes with ischemic CRVO.

CONCLUSION: With RON clinically relevant improvements on a long-term basis seem achievable. Patients with nonischemic CRVO may respond more favorably than patients with ischemic CRVO.