Successful erbium:YAG laser-induced chorioretinal venous anastomosis for the management of ischemic central retinal vein occlusion

Abstract.

Background: Central retinal vein occlusion (CRVO) is a disorder with potentially blinding complications, particularly when associated with retinal ischemia. There is no reliable treatment for ischemic CRVO. Methods: We developed a new approach for ischemic cases of CRVO consisting of vitrectomy, posterior hyaloid detachment, and four erbium:YAG laser-induced chorioretinal anastomoses, one in each quadrant. Results: We report two cases of ischemic CRVO treated with this approach, with initial visual acuity of count fingers at 30 cm and hand movements respectively. After the surgery, there was resolution of hemorrhages and macular edema and visual improvement to 20/400 in the first case and to 20/180 in the second case. In both cases, there was successful creation of chorioretinal anastomoses, and there was no anterior segment neovascularization or other complications related to the surgery. Conclusion: This treatment shows promise in the management of the ischemic cases of CRVO, and further evaluation is justified.