A cinical study of combined therapy for ischemic central retinal vein occlusion

Abstract

Objective This study was designed to assess the clinical effect of combined therapy,which included panretinal photocoagulation (PRP),pars plana vitrectomy (PPV),radial optic neurotomy(RON) and intravitreal Triamcinolone Acetonide (IVTA) for iscbemic central retinal vein occlusion (CRVO)And the mechanism and safety of combined therapy were also discussed in the study.Methods38 eyes of 38patients met the selection criteria were enrolled in the study,and were divided into three groups.Group 1 (14eyes of 14 patients) received PRP,PPV,RON and IVTA 2mg.Group 2 (13 eyes of 13 patients) received PRP,PPV,RON and IVTA 4mg.Group 3 (11 eyes of 11 patients) received PRP,RON and IVTA 4mg.The averagefollow-up was longer than 6 months.The major observed criteria before and alto treatment included best correct visual acuity,intraocular pressure,fimdus fluorescein angiography (FFA),optical coherence tomography(OCT) and so on.Results At the end of follow-up,best correct visual acuity improved in 34 eyes (89.47%).The best correct visual acuity at 3 day,1,3,6 months and last visit were much better than pretreatment(P<0.05).The results of FFA show that arm-retinal circulation time and retinal circulation time at 1,3,6 months weresignificantly shorter than pretreatment (P<0.01).OCT show that the central macular thickness was significantlydecreased postoperatively(P<0.01).Multifocai electroretinogram (mfERG) and primetry threshold of central 30degree also show obvious improvement postoperatively (P<0.01).Complications were rare during and alter theoperation.Conclusions Combined therapy could significantly alleviate macular edema and improve the visualfunction for patients of iscbemic CRVO.It could also reduce the complications of IVTA significantly. Key words: Central retinal vein occlusion; Radialopticneurotomy(RON); TriamcinoloneAcetonide(TA)