放射状视神经切开术治疗缺血型视网膜中央静脉阻塞合并黄斑水肿的疗效观察

Radial optic neurotomy for ischemic central retinal vein occlusion with macular edema

目的观察放射状视神经切开术(RON)治疗缺血型视网膜中央静脉阻塞(CRVO)合并黄斑水肿的效果。方法回顾分析6例缺血型CRVO合并黄斑水肿患者行玻璃体切割联合RON治疗的临床资料,对比观察患者手术前后视力、荧光素眼底血管造影(FFA)、光相干断层扫描(OCT)检查结果,重点观察黄斑厚度、视网膜静脉充盈、视网膜出血和视盘水肿的改善情况。结果6例患者手术后视力均有不同程度提高,视网膜出血明显减少,5例患者黄斑水肿不同程度改善,4例患者视网膜静脉扩张改善,2例合并视盘水肿的患者手术后视盘水肿消失。结论RON能够改善缺血型CRVO合并的黄斑水肿,但不能排除治疗效果和玻璃体切割手术有关。

Objective To observe the therapeutic effect of radial optic neurotomy (RON) for ischemic central retinal vein occlusion (CRVO) with macular edema. Methods The clinical data of 6 patients with ischemic CRVO combined with macular edema who had been treated with vitrectomy and radial optic neurotomy were retrospectively analyzed. The pre-and post-operative visual acuity, results of fundus fluorescein angiography (FFA) and optic coherence tomography (OCT), including the macular thickness, fluorescein filling in retinal veins, retinal hemorrhages and papilloedema were analyzed and compared. Results In the 6 patients, the visual acuity increased in different degrees and retinal hemorrhages decreased evidently. Macular edema was alleviative in 5 patients, retinal vein dilatation meliorated in 4, and papilloedema disappeared in 2. Conclusion RON may alleviate macular edema in patients with ischemic CRVO, but the relation of the therapeutic effect and vitrectomy can not be eliminated.