Radiäre Optikusneurotomie bei ischämischer Zentralvenenthrombose

Abstract

Loss of visual acuity due to ischemic retinal vein occlusion (RVO) is still a major problem in ophthalmology. Prognosis is poor and loss of vision is a severe risk. New approaches for treatment like systemic fibrinolysis and surgical procedures have been suggested. In a clinical trial 8 patients with ischemic CRVO underwent surgical decompression. Strict criteria of inclusion were maintained. Radial optic neurotomy (RON) was performed 0.25-5 months after retinal vein occlusion. Follow up-time was 3 months. Visual acuity and incidence of typical complications after RVO were the main points of interest in our scientific evaluation. Visual acuity improved significantly after the surgical procedure. For ischemic CRVO EDTRS charts increased from logMAR 1.0 (decimal 0.17) to 0.68 (0.30) at 3 months after surgery. Surgical or early complications did not occur within 3 months. The recovery of retinal blood flow during fluorescein angiography was investigated in 75 % of the patients. A resolution of non perfusion-areas could be detected in 50 % of the eyes. For patients with retinal vein occlusion RON seems to be a safe and feasible procedure. The results indicate the potential to improve visual acuity while typical complications due to surgery or vein occlusion did not occur during the first three months.