Optic nerve sheath decompression for progressive central retinal vein occlusion.

OBJECTIVE: To review our results with optic nerve sheath decompression (ONSD) for progressive central retinal vein occlusions (CRVO). METHODS: Patients selected all had evidence of progressively worsening CRVO, a component of optic nerve swelling, and most were already monocular from prior disease in the contralateral eye. ONSD was performed using a nasal approach under retrobulbar anesthesia. RESULTS: Eight eyes from 8 patients with a mean follow-up of 12 months were analyzed. Six patients improved, 2 worsened. Mean preoperative visual acuity was 20/160, and mean final postoperative visual acuity was 20/70. No complications occurred. Nonischemic CRVOs, patients < 65 years old, and those undergoing ONSD within 3 months of presentation seemed to do better. CONCLUSION: ONSD may improve vision or stabilize visual loss in patients with progressive CRVO.