RADIAL OPTIC NEUROTOMY, INTERNAL LIMITING MEMBRANE PEELING AND INTRAVITREAL TRIAMCINOLONE IN THE OCCLUSION OF THE CENTRAL RETINAL VEIN OCCLUSION.

Purpose: to describe the effect of the radial optic neurotomy (RON) associated to the internal limiting membrane (ILM) peeling and intravitreal triamcinolone acetonide injection in the management of the central retinal vein occlusion (CRVO) with cystoid macular edema. Methods: Eight consecutive patients (mean age: 58.8±3) with CRVO and cystoid macular edema were enrolled. Preoperatively, fluorescein angiography showed in all patients ipoperfusion < than 10 papillary diameters and cystoid macular edema, mean macular thickness measured by OCT was 630.37 ± 45.75, mean best correct visual acuity (BCVA) was 1.2 ± 0.12 LogMAR and mean intraocular pressure (IOP) was 14.87 ± 1.12. The surgical procedure was performed at least 15 days after the diagnosis and it consisted of pars plana vitrectomy, radial optic neurotomy in the nasal sector of the optic nerve, indocyanine green–assisted ILM peeling, and intravitreal injection of 4 mg of triamcinolone acetonide. Mean follow up was 4.1 ± 1.5 months. Main outcome measures included best correct visual acuity (BCVA), fluorescein angiography, macular thickness and IOP was evaluated at 7 days and 1, 2 and 3 months. Results: At the end of the follow up mean visual acuity was 0.98 ± 0.1 LogMAR (p=0.0003), the improvement of the retinal perfusion and the reduction of the macular leakage were achieved in all eyes, mean macular thickness was 360.37 ± 52.27 (p < 0.0001), mean intraocular pressure was 15.5 ± 0.75 (p=0.21). Not any complications were observed Conclusions: Radial optic neurotomy associated to internal limiting membrane peeling and intravitreal triamcinolone injection in the management of central retinal vein occlusion resulted in significant improved visual acuity and decresed macular edema