Long-term effects of radial optic neurotomy for central retinal vein occlusion consecutive interventional case series

Purpose To investigate the long-term (minimum 24 months follow-up) clinical results of radial optic neurotomy (RON) following a pars plana vitrectomy (PPV) with internal limiting membrane peeling as treatment for central retinal vein occlusion (CRVO). Methods Interventional case series of 14 consecutive patients (14 eyes) with CRVO who were treated with a PPV combined with RON within 1 year of diagnosis. Results Median baseline visual acuity (VA) was 1.05 logMAR (approximate to 0.09 Snellen) in the affected eye. The follow-up period ranged from 24 to 48 months postoperatively, median 30 months. At the 24-month follow-up examination, median VA was 1.005 logMAR in the affected eye-a significant improvement (p=0.013). Six patients (43%) gained 1 or more lines of VA (mean VA gain=1.7 lines), while the VA of four patients (29%) improved by 3 or more lines. The eyes with nonischemic CRVO demonstrated a significantly higher improvement in VA (p=0.0007) than the eyes with ischemic CRVO. Conclusion With RON clinically relevant improvements on a long-term basis seem achievable. Patients with nonischemic CRVO may respond more favorably than patients with ischemic CRVO.