Histopathologic findings after radial optic neurotomy in central retinal vein occlusion

PURPOSE: Radial optic neurotomy (RON) in central retinal vein occlusion (CRVO) is a novel strategy that is aimed at relief of mechanical pressure on the central retinal vein. We report on histopathologic findings in a human eye 18 weeks after RON. DESIGN: Interventional case report. METHODS: Eighteen weeks after RON for ischemic CRVO, an eye was enucleated because of neovascular glaucoma and examined histologically. RESULTS: Histopathologic evidence demonstrated displaced fragments of Bruch's membrane surrounded by retinal tissue at the nasal side of the papilla. A discrete scar was noted at this site that reached the cribriform plate without involving the adjacent sclera or the retinal vessels. The optic nerve showed advanced atrophy with a small temporal sector of viable nerve fibers. CONCLUSIONS: Histopathologic findings after RON do not provide evidence for the postulated mechanism of action. It appears prudent to further evaluate this technique before its general implementation in the management of CRVO.