Massive hemorrhagic retinal detachment during radial optic neurotomy
Kaori Takaya1, Yukihiko Suzuki, Mitsuru Nakazawa
1Department of Ophthalmology, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
Summary
Radial optic neurotomy (RON) for central retinal vein occlusion (CRVO) can cause arterial bleeding. Liquid perfluoro-carbon infusion effectively stopped bleeding from the RON incision site in a case study.
Area of Science:
- Ophthalmology
- Vascular Surgery
Background:
- Central retinal vein occlusion (CRVO) is a condition causing vision loss.
- Radial optic neurotomy (RON) is a surgical procedure sometimes used for CRVO.
Observation:
- A patient with CRVO experienced significant arterial bleeding during RON surgery.
- Standard methods to control bleeding, including elevating the infusion bottle, were ineffective.
Findings:
- Liquid perfluoro-carbon infusion successfully achieved hemostasis by direct pressure at the bleeding site.
- The patient developed hemorrhagic retinal detachment and vitreous hemorrhage post-operatively, which were managed surgically.
- Long-term follow-up showed gradual absorption of the retinal detachment and stable visual acuity.
Implications:
- RON for CRVO carries a risk of arterial bleeding.
- Liquid perfluoro-carbon may be an effective emergency treatment for arterial bleeding during ophthalmic procedures like RON.
