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Journals / Retina-Vitreus / 2006 / Cilt: 14 - Sayı: 4

Pars plana vitrectomy, internal limiting membrane peeling and radial optic neurotomy in central retinal vein occlusions

Santral retinal ven tıkanıklıklarında pars plana vitrektomi, internal limitan membran soyulması ve radyal optik nörotomi

Mehmet ÇAKIR
Tunç OVALI
Canan Aslı UTİNE
Pages
257–262
DOI
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AI Summary & Key Takeaways

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

For CRVO management, multi-centered randomised and controlled studies are needed, in order to define RON indication and appropriate treatment timing.

📌 3 Key Takeaways

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Objective & Hypothesis:Purpose: To evaluate the efficiency of vitrectomy, internal limiting membrane (ILM) peeling and radial optic neurotomy (RON) performed for internal optic decompression, in cases with central retinal vein occlusion (CRVO).
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Key Findings & Data:Materials and Methods: Pars plana vitrectomy (PPV), ILM peeling and RON were performed in 7 eyes of 7 cases with CRVO, whose visual acuities were 0.1 or less in Snellen lines and who had preoperative period of at least 1 month.
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Conclusion & Impact:For CRVO management, multi-centered randomised and controlled studies are needed, in order to define RON indication and appropriate treatment timing.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Purpose: To evaluate the efficiency of vitrectomy, internal limiting membrane (ILM) peeling and radial optic neurotomy (RON) performed for internal optic decompression, in cases with central retinal vein occlusion (CRVO). Materials and Methods: Pars plana vitrectomy (PPV), ILM peeling and RON were performed in 7 eyes of 7 cases with CRVO, whose visual acuities were 0.1 or less in Snellen lines and who had preoperative period of at least 1 month. Photocoagulation was not done in any of the patients. In order to evaluate the outcomes of RON; full ophthalmological examination, colored fundus photography and fluorescein angiographies were done preoperatively and postoperatively. Results: The mean period between CRVO development and surgery was 19.29±23.21 weeks (range:4-60); the mean postoperative follow-up period was 21.57±6.92 months (range:12-30). The mean visual acuity was 0.03±0.35 (0.01-0.1) preoperatively, 0.05±0.38 (0.01-0.1) postoperatively at the last followup (p=0.421). Fundus fluorescein angiography (FFA) revealed significant decrease in vascular dilatation and tortuosity in all 7 cases postoperatively. However, there were no significant changes in ischemic areas and macular edema. Chorioretinal anastomosis was detected in 3 of the 7 cases (43%). Postoperatively, 1 case had nasal artery branch occlusion and 1 case had epiretinal membrane formation and gliosis in RON site. None of the cases had postoperative rubeosis iridis or neovascular glaucoma. Conclusion: In CRVO cases, PPV and RON results in significant improvement in angiographic vascular dilatation and tortuosity in early postoperative period, but it is not associated with any significant change in ischemia. For CRVO management, multi-centered randomised and controlled studies are needed, in order to define RON indication and appropriate treatment timing.

Özet

Amaç: Santral retinal ven tıkanıklığı (SRVT) gelişen olgularda internal optik dekompresyon amacıyla yapılan vitrektomi, iç limitan membran (İLM) soyulması ve radyal optik nörotominin (RON) etkinliğini değerlendirmek. Gereç ve Yöntem: Santral retinal ven tıkanıklığı gelişen, görme seviyesi 0.1 Snellen sırası ve altında olan ve en az 1 ay bekleme süresi olan 7 hastanın 7 gözüne pars plana vitrektomi (PPV), iç limitan membran soyulması ve radyal optik nörotomi (RON) uygulandı. Hiçbir hastaya fotokoagulasyon yapılmadı. RON sonuçlarını değerlendirmek için cerrahi öncesi ve sonrası oftalmolojik muayene, renkli fundus fotoğrafları ve flöresein anjiografileri çekildi. Bulgular: SRVT gelişimi ile cerrahi arası süre ortalama 19.29±23.21 (4-60) hafta; postoperatif takip süresi ortalama 21.57±6.92 (12-30) aydı. Tedavi öncesi ortalama görme keskinliği 0.03±0.35 (0.01-0.1) iken, postoperatif son kontrolde görme keskinliği 0.05±0.38 (0.01-0.1) idi (p=0.421). Fundus flöresein anjiografisinde (FFA) radyal optik nörotomi uygulanan 7 olguların tümünde postoperatif damar dilatasyonu ve kıvrımlarında belirgin azalma saptandı.Fakat iskemik alanlarda ve makula ödeminde belirgin değişiklik olmadı. Üç olguda (%43) korioretinal anastomoz saptandı. Komplikasyon olarak bir olguda postoperatif nazal arter dal oklüzyonu gelişti. Bir olguda ise epiretinal membran ve RON yerinde gliozis gelişti. Hiçbir olguda cerrahi sonrası rubeozis iridis ve neovasküler glokom saptanmadı. Sonuç: SRVT olgularında PPV ve RON, anjiografik olarak erken dönemde damar dilatasyonu ve kıvrımlarında belirgin düzelme sağlamakta, fakat iskemide belirgin değişiklik yapmamaktadır. SRVT’de RON endikasyonu ve uygun tedavi zamanlamasını belirlemek için çok merkezli, randomize ve kontrollü çalışmalar gerekmektedir.

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Cite This Article

ÇAKIR, M., OVALI, T., UTİNE, C. A. (2006). Pars plana vitrectomy, internal limiting membrane peeling and radial optic neurotomy in central retinal vein occlusions. Retina-Vitreus, Cilt: 14 - Sayı: 4, 257–262. https://ajindex.com/articles/305339

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