Jennifer S. Weizer

Radial optic neurotomy as treatment for central retinal vein occlusion

PURPOSEnTo review our initial experience with radial optic neurotomy as treatment for retinal vein occlusion.nnnDESIGNnInterventional case series.nnnMETHODSnnnnPATIENT POPULATIONnfive patients (four with central retinal vein occlusion and one with hemiretinal vein occlusion).nnnINTERVENTIONnPars plana vitrectomy with radial optic neurotomy was performed in each case.nnnMAIN OUTCOME MEASURESnBest-corrected visual acuity, presence of macular edema, perfusion status, and time to venous phase of the angiogram were reviewed retrospectively.nnnRESULTSnMean preoperative visual acuity was 4/200. Preoperatively, the vein occlusion was perfused in one (20%), nonperfused in one (20%), and indeterminate in three (60%). Mean follow-up time was 4.5 months. Mean postoperative visual acuity was 20/400 at last follow-up. Four patients (80%) had improvement in visual acuity and one (20%) worsened. Two patients (40%) improved to 20/80 postoperatively. In four cases (80%), disk congestion improved and intraretinal hemorrhage reabsorbed more quickly than would be expected without treatment. Time to the venous phase of fluorescein angiography improved slightly in three cases (60%) postoperatively. Perfusion status as determined by fluorescein angiography was not significantly altered postoperatively. One patient (20%) had resolution of macular edema postoperatively as shown by volumetric optical coherence tomography. One patient developed choroidovitreal neovascularization and one developed iris neovascularization postoperatively, both of which responded to panretinal photocoagulation.nnnCONCLUSIONSnRadial optic neurotomy may improve visual acuity in eyes with central retinal vein occlusion, although choroidovitreal neovascularization from the neurotomy site can occur. Further study is needed to determine its role in the management of central vein occlusion.

Lisch nodules after trabeculectomy

The development of Lisch nodules in an eye that had undergone trabeculectomy with mitomycin C is described. Complete ophthalmologic examinations and genetic testing of a 12-year-old boy were performed. Lisch nodules can develop after trabeculectomy without the systemic manifestations of neurofibromatosis type 1.

All about Your Eyes

A concise, easy-to-understand reference book, All about Your Eyes tells you what you need to know to care for your eyes and what to expect from your eye doctor.nnIn this reliable guide, leading eye care experts:nn—explain how healthy eyes worknn—describe various eye diseases, including pink eye, cataract, glaucoma, age-related macular degeneration, and diabetic retinopathynn—provide up-to-date information on eye surgery, including refractive, laser, and cosmeticnnFor each eye problem, the authors describe in simple, straightforward languagenn—what it isnn—the symptomsnn—what, if anything, you can do to prevent itnn—when to call the doctornn—the treatmentnn—the likelihood of recoverynnAll about Your Eyes includes a glossary of technical terms and, following each entry, links to web sites where further information may be found.