A retrospective cohort study of radial optic neurotomy for severe central retinal vein occlusions

Abstract Background: Radial optic neurotomy (RON) is a new surgical procedure that has, until now, been studied only in a case series format. This study was designed to evaluate the efficacy of RON in improving visual acuity in patients suffering from central retinal vein occlusion (CRVO) with visual acuity equal to or worse than 20/100. Methods: A retrospective cohort study was conducted of consecutive CRVO patients, consisting of 19 who underwent RON and 38 observation subjects matched on presenting visual acuity. Results: The observation group worsened by 0.25 logMAR units from baseline, whereas the surgery group improved by 0.29 logMAR. Multivariate linear regression modelling found that, having controlled for other significant predictors and confounders, the change in visual acuity in the surgery patients was 0.63 logMAR units better than in the observation patients. Interpretation: Our data suggest that RON is a promising treatment for visual acuity loss in severe CRVO causing visual acuity equal to or worse than 20/100. These results should be interpreted cautiously because of the limitations of the study, including the retrospective study design and the use of Snellen visual acuity. Our data suggest that further evaluation of RON is warranted.