关于放射状视神经切开术治疗视网膜中央静脉阻塞的争议

Controversy about radial optic neurotomy as a treatment of central retinal vein occlusion

由于视网膜中央静脉阻塞(centralretinalveinocclusion,CRVO)的发病机制尚不清楚,因此目前的治疗方案包括药物治疗、激光治疗和手术治疗均无明确肯定的效果。近年国内外一些眼科医生在鼻侧视盘做视神经放射状切开术(radialopticneurotomy,RON),拟在筛板水平松解巩膜环、筛板和邻近的巩膜,以减轻对血管的压迫,增加视网膜中央静脉(centralretinalvein,CRV)的管径和血流以及清除静脉血栓。但有学者对此治疗方法的原理和效果提出质疑,并展开激烈地争论。然而,对RON手术有效性的评价,最终取决于随机对照的临床实验结果。

Since the pathogenesis of central retinal vein occlusion （CRVO） is not well understood, there is no known effective treatment for CRVO. Radial optic neurotomy （RON） is performed on the nasal side of the disk by some ophthalmologists. The goal and endpoint of the surgical procedure is to make a relaxing incision at the level scleral ring, cribriform plate and adjacent sclera, thus relieving any unnecessary compression on the outfown vessels and clearing the venous thrombus.But some scholars call in questions about the principle and effect of RON and make a violent controversy. However, the evaluation about the effect of RON lie in randomized clinical trial result at last.