Radial Optic Neurotomy for Central Retinal Vein Occlusion

Arévalo, J. Fernando; Garcia, Reinaldo A.; Wu, Lihteh; Rodriguez, Francisco J.; Dalma-Weiszhausz, José; Quiroz‐Mercado, Hugo; Morales-Cantón, Virgilio; Roca, José A.; Berrocal, María H.; Graue-Wiechers, Federico; Robledo, V.

doi:10.1097/iae.0b013e3181744153

Cited by 47 publications

(9 citation statements)

References 39 publications

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“…Radial neurotomy has been suggested as a therapy for CRVO [110,111,112,113]. However, randomized prospective trials have not yet shown beneficial effects of radial neurotomy in the treatment of CRVO, so that it is unclear whether the technique should be recommended [86].…”

Section: Surgical Approaches To Treating Rvomentioning

confidence: 99%

Section: Surgical Approaches To Treating Rvomentioning

confidence: 99%

“…RON has been associated with a potential risk of laceration of the central retinal artery or central retinal vein, optic nerve fiber damage with visual field loss, globe perforation, retinal detachment, choroidal neovascularization at the neurotomy site, and anterior segment neovascularization [110,113,120]. The PACORES (Pan-American Collaborative Retina Study) Group evaluated the complications after RON for CRVO [110]. Complications occurred in 71.2% of cases, including cataract (23.2%), vitreous hemorrhage (20.5%), persistent macular edema (20.5%), neovascular glaucoma (9.5%), anterior segment neovascularization (6.8%), retinal detachment (4.1%) as well as phthisis bulbi, choroidovitreal neovascularization, central retinal artery perforation and optic nerve atrophy (1.3% each).…”

Section: Surgical Approaches To Treating Rvomentioning

confidence: 99%

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Management of Retinal Vein Occlusion – Consensus Document

et al. 2011

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Retinal vein occlusion (RVO) can have severe consequences for the people affected by the disease, including visual loss with costly social repercussions. Currently, there is no European consensus with regard to the management of RVO. Following a careful review of the medical literature as well as the data from several clinical trials, a collaborative group of retina specialists put forth practical recommendations based on the best available scientific evidence for the clinical approach to RVO. Taking into consideration the recent advances in diagnostic tools and management options, the present document aims to provide the European ophthalmologists with guidelines for clinical practice to the benefit of their patients.

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Section: Surgical Approaches To Treating Rvomentioning

confidence: 99%

Section: Surgical Approaches To Treating Rvomentioning

confidence: 99%

Section: Surgical Approaches To Treating Rvomentioning

confidence: 99%

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Management of Retinal Vein Occlusion – Consensus Document

et al. 2011

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“…Various medical and surgical interventions have been tried, including argon laser panretinal photocoagulation (Hayreh 1990), macular grid photocoagulation (CVOS Group 1995), tissue plasminogen activator (Everett 2006), oral pentoxifylline (Park 2007), hyperbaric oxygen therapy (Wright 2007), radial optic neurotomy (Arevalo 2008; Hasselbach 2007; Opremcak 2006; Zambarakji 2005) and pars plana vitrectomy with internal limiting membrane peeling (DeCroos 2009; Park 2010; Raszewska-Steglinska 2009), but these have not been successful. More recently, an RCT comparing laser-induced chorioretinal venous anastomosis to sham treatment in adults with non-ischemic CRVO-ME of three to twelve months duration demonstrated moderate efficacy, especially in the 76% who developed a functioning anastomosis following laser treatment, and the visual acuity advantage compared to control was maintained at 18 months (McAllister 2010).…”

Section: Introductionmentioning

confidence: 99%

Anti-vascular endothelial growth factor for macular edema secondary to central retinal vein occlusion

Braithwaite

Nanji

Greenberg

2010

Cochrane Database of Systematic Reviews

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Background Central retinal vein occlusion (CRVO) is a common retinal vascular disorder in which macular edema (ME) may develop, with a consequent reduction in visual acuity. The visual prognosis in CRVO-ME is poor in a substantial proportion of patients, especially those with the ischemic subtype, and until recently there has been no treatment of proven benefit. Macular grid laser treatment is ineffective, and whilst a few recent randomized controlled trials (RCTs) suggest short-term gains in visual acuity with intravitreal steroids for patients with non-ischemic CRVO-ME, there is no established treatment for ischemic CRVO-ME. Anti-vascular endothelial growth factor (anti-VEGF) agents have been used to treat ME resulting from a variety of causes and may represent a treatment option for CRVO-ME. Objectives To investigate the effectiveness and safety of intravitreal anti-VEGF agents in the treatment of CRVO-ME. Search strategy We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2010, Issue 8), MEDLINE (January 1950 to August 2010), EMBASE (January 1980 to August 2010), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to August 2010), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (January 1937 to August 2010), OpenSIGLE (January 1950 to August 2010), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com) and ClinicalTrials.gov (www.clinicaltrials.gov). There were no language or date restrictions in the search for trials. The electronic databases were last searched on 10 August 2010. Selection criteria We considered RCTs that compared intravitreal anti-VEGF agents of any dose or duration to sham injection or no treatment. We focused on studies that included individuals of any age or gender with unilateral or bilateral disease and a minimum of six months follow up. Secondarily, we considered non-randomized studies with the same criteria, but did not conduct a separate electronic search for these. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Main results We found two RCTs that met the inclusion criteria after independent and duplicate review of the search results. These RCTs utilized different anti-VEGF agents which cannot be assumed to be directly comparable. We, therefore, performed no meta-analysis. Evidence from these trials and from other non-randomized case series is summarized in this review. Authors’ conclusions Ranibizumab and pegaptanib sodium have shown promise in the short-term treatment of non-ischemic CRVO-ME. However, effectiveness and safety data from larger RCTs with follow up beyond six months are not yet available. There are no RCT data on anti-VEGF agents in ischemic CRVO-ME. The use of anti-VEGF agents to treat this condition therefore remains experimental.

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“…Other possible complications of this procedure are laceration of central retinal artery or vein, globe perforation, retinal detachment, vitreous hemorrhage, neovascular glaucoma, or choroidal neovascularization (CNV) [36, 41, 42]. Consequently, benefits of RON appear to be controversial and its efficacy remains to be proven in prospective, RCTs.…”

Section: Surgical Optionsmentioning

confidence: 99%

Practical Management of Retinal Vein Occlusions

Spina¹,

Benedetto²,

Parodi³

et al. 2012

Ophthalmol Ther

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Retinal vein occlusion (RVO) is the second most common cause of visual impairment due to retinal disease after diabetic retinopathy. Nowadays, the introduction of new, powerful diagnostic tools, such as spectral domain optical coherence tomography, and the widespread diffusion of intravitreal drugs, such as vascular endothelial grow factor inhibitors or implantable steroids, have dramatically changed the management and prognosis of RVO. The authors aim to summarize and review the main clinical, diagnostic, and therapeutic aspects of this condition. The authors conducted a review of the most relevant clinical trials and observational studies published within the last 30 years using a keyword search of MEDLINE, EMBASE, Current Contents, and Cochrane Library. Furthermore, for all treatments discussed, the level of evidence supporting its use, as per the US Preventive Task Force Ranking System, is provided.

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Radial Optic Neurotomy for Central Retinal Vein Occlusion

Abstract: RON may improve visual acuity in some eyes with CRVO, but complications are common. In our series, surgery by itself did not seem to improve the outcome of CRVO when compared with its natural history.

Cited by 47 publications

References 39 publications

Management of Retinal Vein Occlusion – Consensus Document

Management of Retinal Vein Occlusion – Consensus Document

Anti-vascular endothelial growth factor for macular edema secondary to central retinal vein occlusion

Practical Management of Retinal Vein Occlusions

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