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Journals / Retina-Vitreus / 2008 / Cilt: 16 - Sayı: 2

Santral retinal ven tıkanıklığında intravitreal triamsinolonlu veya triamsinolonsuz radyal optik nörotomi sonuçları

Results of radial optic neurotomy with or without ıntravitreal triamcinolone for central retinal vein occlusion

Tuğrul ALTAN
Nur ACAR
Ziya KAPRAN
Yaprak Banu ÜNVER
Sezin ÖZDOĞAN
Yaşar KÜÇÜKSÜMER
Pages
101–106
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusions: RON surgery with or without peroperative IVTA led to a significant decrease in central macular thickness but its functional success is very limited in eyes with preoperative BCVA of less than 20/200 and probably is not better than the natural history.

📌 3 Key Takeaways

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Objective & Hypothesis:Purpose: To evaluate the efficacy of radial optic neurotomy (RON) with or without intravitreal triamcinolone in improving visual acuity in central retinal vein occlusion (CRVO).
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Key Findings & Data:Materials and Methods: We performed vitrectomy and RON to 16 eyes of 16 patients with CRVO with a best corrected visual acuity (BCVA) of 20/200 or less.
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Conclusion & Impact:Conclusions: RON surgery with or without peroperative IVTA led to a significant decrease in central macular thickness but its functional success is very limited in eyes with preoperative BCVA of less than 20/200 and probably is not better than the natural history.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Triamsinolon · Vitrektomi · İntraoperatif komplikasyonlar

Abstract

Purpose: To evaluate the efficacy of radial optic neurotomy (RON) with or without intravitreal triamcinolone in improving visual acuity in central retinal vein occlusion (CRVO). Materials and Methods: We performed vitrectomy and RON to 16 eyes of 16 patients with CRVO with a best corrected visual acuity (BCVA) of 20/200 or less. Eight of them re- ceived an injection of 4mg intravitreal triamcinolone (IVTA) at the completion of the surgery. The major outcome pa- rameter was defined as an improvement of BCVA of 2 or more lines and final BCVA better than 20/200. Decrease in central macular thickness was our secondary outcome parameter. Intraoperative and postoperative complications were also evaluated. Results: Eleven (68.8%) of the eyes were evaluated as ischemic based on fluorescein angiography and presence of relative afferent pupillary defect. Only 2 (12.5%) patients had BCVA of better than 20/200 postoperatively. Central macular thickness was significantly reduced from 811±303 &#956; to 444±276 &#956; (p<0.01). Preoperative visual acuity and age were significant factors in affecting final BCVA of better than 20/200 (p=0.02 and p=0.05, respectively). One patient underwent trabeculectomy because of intractable open angle glaucoma. One additional patient developed neovascular glaucoma and was treated with diod laser cyclophotocoagulation. Conclusions: RON surgery with or without peroperative IVTA led to a significant decrease in central macular thickness but its functional success is very limited in eyes with preoperative BCVA of less than 20/200 and probably is not better than the natural history.

Özet

Amaç: Santral retinal ven tıkanıklığında (SRVT) intravitreal triamsinolonlu veya triamsinolonsuz radyal optik nöroto- minin (RON) görme keskinliğini iyileştirmedeki etkinliğini değerlendirmek. Gereç ve Yöntemler: En iyi düzeltilmiş görme keskinliği (EİDGK) 20/200 veya altında olan 16 SRVT hastasının 16 gözüne RON uyguladık. Gözlerden sekizine ameliyatın bitiminde 4mg triamsinolon intravitreal olarak uygulan- dı (IVTA). EİDGK’da 2 sıra veya daha fazla artış ve sonuç EİDGK’nın 20/200 üzerinde olması ana hedef olarak be- lirlendi.Merkezi retina kalınlığındaki azalma ikincil hedefti. Ameliyat esnasında ve sonrasındaki komplikasyonlar da değerlendirildi. Bulgular: Floresein anjiyografiye dayanılarak gözlerin 11’i (%68.8) iskemik olarak değerlendirildi. Ameliyat son- rası dönemda yalnızca 2 (%12.5) hastanın EİDGK’sı 20/200’den daha iyiydi. Merkezi retina kalınlığı anlamlı bir şekilde 811±303 μ’dan 444±276 μ’a geriledi (p<0.01). ameliyat öncesi EİDGK ve yaş 20/200’den daha iyi sonuç görmeye ulaşmayı etkileyen faktörler olarak saptandı (sı- rasıyla p=0.02 ve p=0.05). Bir hastaya tedaviye dirençli glokom nedeniyle trabekülectomi uygulandı. Bir hastada da neovasküler glokom gelişti ve diyod lazer siklofotokoa- gülasyon ile tedavi edildi. Sonuç: İVTA’lı veya IVTA’sız RON cerrahisi merkezi retina ka- lınlığında anlamlı azalma sağladı fakat ameliyat öncesi EİDGK’sı 20/200 altında olan gözlerde fonksiyonel başa- rısı çok sınırlıdır ve muhtemelen doğal seyirden daha iyi değildir.

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Cite This Article

ALTAN, T., ACAR, N., KAPRAN, Z., ÜNVER, Y. B., ÖZDOĞAN, S., KÜÇÜKSÜMER, Y. (2008). Santral retinal ven tıkanıklığında intravitreal triamsinolonlu veya triamsinolonsuz radyal optik nörotomi sonuçları. Retina-Vitreus, Cilt: 16 - Sayı: 2, 101–106. https://ajindex.com/articles/305228

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