Laser-induced chorioretinal venous anastomosis for treatment of nonischemic central retinal vein occlusion.

Abstract

To determine whether a chorioretinal venous anastomosis could be created in humans and to evaluate the influence this has on patients with nonischemic central retinal vein occlusions in whom progressive visual loss developed. Retrospective study. A total of 24 patients with nonischemic central retinal vein occlusions and progressive visual loss. An attempt was made to create a chorioretinal venous anastomosis using laser photocoagulation to enable obstructed venous blood to enter the choroid, thus bypassing the site of occlusion. Visual acuity, funduscopic appearance, and rapid sequence fluorescein angiograms. A successful chorioretinal venous anastomosis was created in eight cases (33%), with improvement in visual acuity and resolution of the funduscopic appearance of venous occlusion in all eight cases. Of the 16 patients (67%) in whom an anastomosis was not successfully created, the ischemic form of central retinal vein occlusion developed in five (31%), and eight (50%) were left with various degrees of macular damage and reduced visual acuity. Peripheral chorioretinal venous anastomoses can be created in a nonischemic central retinal vein occlusion and appear to be well tolerated. This technique may have some value in the treatment of patients with this condition; however, to address this fully, a properly constructed randomized prospective clinical trial will need to be performed.