视乳头切开治疗视网膜中央静脉阻塞

Radial optic neurotomy for treatment of central retinal vein occlusion

目的 观察视乳头切开术 (radialopticneurotomy)治疗视网膜中央静脉阻塞 (centralretinalveinocclu sion ,CRVO)的临床疗效。方法 分析 1 0例行视乳头切开术的患者的术中所见 ,术前术后的视力、眼底彩照、眼底荧光造影 (fundusfluoresceinangiography ,FFA)、光学相干断层扫描 (opticalcoherencetomography ,OCT)、多焦视网膜电图 (multifocalelectroretinography ,mERG)等检查的临床资料。结果 术中 ,视乳头切开后均可见视盘近端视网膜静脉充盈增加。随访期间 7例视力提高 ,1例保持不变 ,2例下降。眼底彩照、FFA发现视网膜出血明显吸收 ,血管变直 ,但有新的无灌注区出现。OCT显示黄斑水肿较术前明显减轻或消失。mERG显示黄斑区反应振幅变化不大。1例患者因严重视网膜下出血行硅油填充术。 1例患者出现黄斑前膜。结论 视乳头切开术是安全有效的手术。

ObjectiveTo evaluate the efficacy and indication of radial optic neurotomy for treatment of central retinal vein occlusion(CRVO). MethodsTen consecutive patients(10 eyes), underwent par plana vitrectomy, vitreous cortex separation and radial optic neurotomy for CRVO. The follow-up period was 6～22 months. Postoperative examination including color fundus photography, fundus fluorescein angiography, optical coherence tomography and multifocal electroretinography were performed. ResultsAll patients showed significant clinical improvement. Visual acuities improved in seven patients. The retinal hemorrhage was significantly absorbed and macular edema disappeared or was dramatically reduced. ConclusionArteriovenous sheathotomy is a safe and effective operation for central retinal vein occlusion.