玻璃体手术治疗视网膜中央静脉阻塞伴黄斑水肿

Objective To observe the clinical therapeutic effects of vitrectomy and radial optic neurotomy (RON) for macular edema secondary to central retinal vein occlusion (CRVO). Methods Thirty-six consecutive patients (36 eyes) were identified duration of macular edema secondary to ischemic CRVO. According to the time of surgery, these patients divided into two groups, the radial optic neurotomy (RON) group, the Pars Planna Vitrectomy/Panretianl Endophotocoagulation (PPV/PE) group. The average follow-up periods were 28.6± 6.3 months. The changes in visual acuity (VA), foveal thickness, visual fiPEd and the case of optic disc were observed and compared. Results The visual acuity (VA) of 4 eyes in the radial optic neurotomy (RON) group and 6 eyes in the Pars Planna Vitrectomy /Panretiani Endopbotocoagulation (PPV/PE) group improved at the first 1 month. Then clinical observation and follow-up more than 1 year, in the radial optic neurotomy (RON) group: visual acuity (VA) had improvement in 8 eyes, 4 remained the same, whereas 2 became worse. The Pars Planna Vitrectomy/Panretianl Endopbotocoagulation (PPV/PE) group: visual acuity (VA) had improvement in 12 eyes, 8 remained the same, whereas 4 became worse. None of both the groups were≥0.5 in BCVA, and 50% were ≥0.1. It was not statistically significant between the two groups which eyes were≥ 0.1 in BCVA at 1 month and 1 year of follow-up (P >0.05 ). OCT showed that all patients were improved at their last follow-up when compared with preoperative foveal thickness. However,4 eyes had optic atrophy in RON group. Conclusions The improvement in visual acuity and macular edema between RON group and PPV/PE group has no statistically significant differences. However, optic atrophy is a major postoperative complication in the RON group. It's better to choose PPV/PE first.

Clinical therapeutic effects of vitrectomy and radial optic neurotomy for macular edema secondarey to central retinal vein occlusion.