Documenta Ophthalmologica

, Volume 116, Issue 2, pp 153–158 | Cite as

Changes of electroretinogram without improvement of retinal circulation after radial optic neurotomy for central retinal vein occlusion

ERG changes after RON for CRVO
  • Eiju Sato
  • Shuichi Yamamoto
  • Kazuha Ogata
  • Mariko Kubota
  • Takeshi Sugawara
  • Satoshi Mizunoya
Case Report


Purpose To evaluate the efficacy of radial optic neurotomy (RON) on retinal function in patients with central retinal vein occlusion (CRVO). Methods Ten eyes of 10 patients with CRVO underwent pars plana vitrectomy and RON. Standardized combined electroretinograms (ERGs) to full-field bright-flash stimuli were recorded preoperatively and, 3 months postoperatively. The best-corrected visual acuity and foveal thickness were also determined, before and 3 months postoperatively. Results The mean best-corrected visual acuity and mean foveal thickness were both significantly improved after vitrectomy and RON. The mean amplitudes of a- and b-waves did not change significantly, but the mean b/a wave ratio was increased significantly after vitrectomy and RON. An improvement of the b/a ratio was observed in six eyes, however, an improvement of retinal circulation was confirmed on postoperative fluorescein angiograms in two of these six eyes. Conclusions Significant improvements were observed in the b/a wave ratio of the standard combined ERGs after surgery in eyes with CRVO. The improvement of retinal function was most likely due to improved oxygenation of retina caused by vitrectomy and not by RON.


Central retinal vein occlusion Electroretinogram Macular edema OCT Radial optic neurotomy Vitrectomy 


  1. 1.
    Opremcak EM, Bruce RA, Lomeo MD, Ridenour CD, Letson AD, Rehmar AJ (2001) Radial optic neurotomy for central retinal vein occlusion. Retina 21:408–415PubMedCrossRefGoogle Scholar
  2. 2.
    Weizer JS, Stinnett SS, Fekrat S (2003) Radial optic neurotomy as treatment for central retinal vein occlusion. Am J Ophthalmol 136:814–819PubMedCrossRefGoogle Scholar
  3. 3.
    Garcia-Arumi J, Boixadera A, Martinez-Castillo V, Castillo R, Dou A, Corcostegui B (2003) Chorioretinal anastomosis after radial optic neurotomy for central retinal vein occlusion. Arch Ophthalmol 121:1385–1391CrossRefGoogle Scholar
  4. 4.
    Nomoto H, Shiraga F, Yamaji H, Kageyama M, Takenaka H, Baba T, Tsuchida Y (2004) Evaluation of radial optic neurotomy for central retinal vein occlusion by indocyanine green videoangiography and image analysis. Am J Ophthalmol 138:612–619PubMedCrossRefGoogle Scholar
  5. 5.
    Karpe G, Uchermann A (1955) The clinical electroretinogram VII The electroretinogram in circulatory disturbances of the retina. Acta Ophthalmol 33:493–516Google Scholar
  6. 6.
    Karpe G, Germanis M (1962) The prognostic value of the electroretinogram in thrombosis of the retinal veins. Acta Ophthalmol Suppl 70:202–229PubMedCrossRefGoogle Scholar
  7. 7.
    Sabates R, Hirose T, McMeel JW (1983) Electroretinography in the prognosis and classification of central retinal vein occlusion. Arch Ophthalmol 101:232–235PubMedGoogle Scholar
  8. 8.
    Hayreh SS, Klugman MR, Podhajsky P, Kolder HE (1989) Electroretinography in central retinal vein occlusion. Correlation of electroretinographic changes with pupillary abnormalities. Graefes Arch Clin Exp Ophthalmol 227:549–561PubMedCrossRefGoogle Scholar
  9. 9.
    Central Vein Occlusion Study Group (1995) A randomized clinical trial of early panretinal photocoagulation for ischemic central vein occlusion. Ophthalmology 102:1434–1444Google Scholar
  10. 10.
    Shinoda K, Ohde H, Mashima Y, Inoue R, Ishida S, Inoue M, Kawashima S, Oguchi Y (2001) On- and off-responses of the photopic electroretinograms in X-linked juvenile retinoschisis. Am J Ophthalmol 131:489–494PubMedCrossRefGoogle Scholar
  11. 11.
    Marmor MF, Holder GE, Seeliger MW, Yamamoto S (2004) International Society for Clinical Electrophysiology of Vision Standard for clinical electroretinography (2004 update). Doc Ophthalmol 108:107–114PubMedCrossRefGoogle Scholar
  12. 12.
    Hayreh SS (2004) Radial optic neurotomy for nonischemic central retinal vein occlusion. Arch Ophthalmol 122:1572–1573PubMedCrossRefGoogle Scholar
  13. 13.
    Vogel A, Holz FG, Loeffler KU (2006) Histopathologic findings after radial optic neurotomy in central retinal vein occlusion. Am J Ophthalmol 141:203–205PubMedCrossRefGoogle Scholar
  14. 14.
    Horio N, Horiguchi M (2005) Central retinal vein occlusion with further reduction of retinal blood flow one year after radial optic neurotomy. Am J Ophthalmol 139:926–927PubMedCrossRefGoogle Scholar
  15. 15.
    Yamamoto S, Saito W, Yagi F, Takeuchi S, Sato E, Mizunoya S (2004) Vitrectomy with or without arteriovenous adventitial sheathotomy for macular edema associated with branch retinal vein occlusion. Am J Ophthalmol 138:907–914PubMedCrossRefGoogle Scholar
  16. 16.
    Yamamoto T, Akabane N, Takeuchi S (2001) Vitrectomy for diabetic macular edema: the role of posterior vitreous detachment and epimacular membrane. Am J Ophthalmol 132:369–377PubMedCrossRefGoogle Scholar
  17. 17.
    Stefansson E, Novack RL, Hatchell DL (1990) Vitrectomy prevents retinal hypoxia in branch retinal vein occlusion. Invest Ophthalmol Vis Sci 31:284–289PubMedGoogle Scholar
  18. 18.
    Mandelcorn MS, Nrusimhadevara RK (2004) Internal limiting membrane peeling for decompression of macular edema in retinal vein occlusion: a report of 14 cases. Retina 24:348–355PubMedCrossRefGoogle Scholar
  19. 19.
    Radetzky S, Walter P, Fauser S, Koizumi K, Kirchhof B, Joussen AM (2004) Visual outcome of patients with macular edema after pars plana vitrectomy and indocyanine green-assisted peeling of the internal limiting membrane. Graefes Arch Clin Exp Ophthalmol 242:273–278PubMedCrossRefGoogle Scholar
  20. 20.
    Matsui Y, Katsumi O, Sakaue H, Hirose T (1994) Electroretinogram b/a wave ratio improvement in central retinal vein obstruction. Br J Ophthalmol 78:191–198PubMedCrossRefGoogle Scholar
  21. 21.
    Yamamoto S, Takatsuna Y, Sato E, Mizunoya S (2005) Central retinal artery occlusion after radial optic neurotomy in a patient with central retinal vein occlusion. Am J Ophthalmol 139:206–207PubMedCrossRefGoogle Scholar
  22. 22.
    Schneider U, Inhoffen W, Grisanti S, Bartz-Schmidt KU (2005) Characteristics of visual field defects by scanning laser ophthalmoscope microperimetry after radial optic neurotomy for central retinal vein occlusion. Retina 25:704–712PubMedCrossRefGoogle Scholar
  23. 23.
    Takaya K, Suzuki Y, Nakazawa M (2006) Massive hemorrhagic retinal detachment during radial optic neurotomy. Graefes Arch Clin Exp Ophthalmol 244:265–267PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Eiju Sato
    • 1
  • Shuichi Yamamoto
    • 1
  • Kazuha Ogata
    • 1
  • Mariko Kubota
    • 1
  • Takeshi Sugawara
    • 1
  • Satoshi Mizunoya
    • 2
  1. 1.Department of Ophthalmology and Visual ScienceChiba University Graduate School of MedicineChibaJapan
  2. 2.Department of OphthalmologyTeikyo University Ichihara HospitalIchiharaJapan

Personalised recommendations