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Radial optic neurotomy still a valid CRVO treatment

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LISBON, Portugal — Physicians should not discount radial optic neurotomy as a treatment for central retinal vein occlusion, said one speaker here.

Marcelo Zas, MD, performed a retrospective review of 17 patients with ischemic central retinal vein occlusion who underwent radial optic neurotomy between 2003 and 2005. All patients had vision of 20/400 or worse at baseline, Dr. Zas said.

Each of the patients underwent pars plana vitrectomy, including an extraction of the posterior hyaloid, and a neurotomy on the nasal side to relax the scleral outlet, Dr. Zas told attendees here at the Euretina conference.

He said 13 patients improved their visual acuity to a range of 20/200 to 20/60. “There were no postoperative complications at up to 24 months,” he said.

Of the remaining four patients, three developed anterior segment neovascularization with secondary glaucoma and the fourth developed a rhegmatogenous retinal detachment secondary to pars plana vitrectomy and required a second surgery, Dr. Zas said.