[Transvitreal optic neurotomy: a new treatment option for centra1 retinal vein occlusion]

ABSTRACT

Central retinal vein occlusion [CRVO] occurs at the scleral outlet where the optic nerve, central retinal artery, and central retinal vein enter the eye; therefore it may be considered a "compartment syndrome" which is defined as a neurovascular compression within this confined space of scleral outlet resulting in tissue ischemia and dysfunction. Transvitreal optic neurotomy [TON] is a new surgical technique advocated for treatment of CRVO. By this procedure and providing surgical relaxation of the scleral outlet, clearing of macular edema and interaretinal hemorrhage and improved retinal blood flow may reestablish. TON may be a beneficial surgical procedure for patients with sever CRVO via decompressing the scleral outlet and by that affecting the optic nerve and the blood supply. In addition to scleral ring relaxation, other postulated mechanisms of effect in TON include development of opticociliary vessels and increased perfusion into pre-existing opticociliary vessels. Preliminary results of TON for CRVO have demonstrated encouraging results; however these results need to be reconfirmed in a randomized clinical trial