網膜中心静脈閉塞症に放射状視神経切開術を施行した7例

Seven cases of central retinal vein occlusion treated by radial optic neurotomy

網膜中心静脈閉塞症7例7眼に放射状視神経切開術を行った。5眼が虚血型，2眼が非虚血型であり，男性6例，女性1例で，年齢は56～74歳（平均67歳）であった。視力は0.01～0.4であった。白内障硝子体同時手術の後，乳頭鼻側を放射状に切開した。3～18か月（平均10.7か月）の観察で，6眼で最終視力が2段階以上改善した。視力は4眼で0.5以上，3眼では0.1未満であった。これら3眼は虚血型で，囊胞様黄斑浮腫が遷延した。5眼で網膜静脈の拡張と蛇行が改善し，3眼で穿刺部位に網脈絡膜静脈吻合が生じた。術中・術後の重篤な合併症はなかった。放射状視神経切開術は網膜中心静脈閉塞症に対して有用であると結論される。

We performed radial optic neurotomy for central retinal vein occlusion（CRVO）in 7 eyes of 7 patients. Five eyes were ischemic and 2 eyes were non-ischemic. The series comprised 6 males and 1 female. The ages ranged from 56 to 74 years,average 67 years. The visual acuity ranged from 0.01 to 0.4. All the eyes received lens removal and pars plana vitrectomy followed by piercing of nasal edge of optic disc by 20G microvitreoretinal blade. Visual acuity improved by 2 lines or over in 6 eyes after follow-up of 3 to 18 months,average 10.7 months. Final visual acuity improved to 0.5 or over in 4 eyes. It was below 0.1 in 3 eyes. These eyes had ischemic CRVO and had persistent cystoid macular edema. Tortuosity and engorgement of retinal veins improved in 5 eyes. Chorioretinal venous anastomosis developed in 3 eyes at the site of neurotomy. Intra- or postoperative complications were consistently absent. These findings show usefulness of radial optic neurotomy for CRVO.