Laser-induced chorioretinal venous anastomosis for non-ischaemic hemi-central vein occlusion

Purpose: To assess the effectiveness and complications of laser-induced chorioretinal venous anastomosis performed on eyes with non-ischaemic hemi-central retinal vein occlusions (hemi-CRVO). Methods: Fourteen eyes with a hemi-CRVO which reduced the visual acuity to 6/24 or less were treated with argon laser photocoagulation in an attempt to create a chorioretinal venous anastomosis between a retinal vein and the choroidal circulation. Results: Laser anastomoses were successfully created in six eyes (43%) and required a mean of 1.8 attempts in each eye. Of the eyes that developed an anastomosis, four had significant visual improvement. The distal retinal venous segment closed off in five eyes and these had prophylactic segmental argon pan-retinal photocoagulation performed. Two eyes had localized fibrovascular proliferation. No permanent vision-threatening complications were observed in any of the 14 eyes over the follow-up period. Conclusions: Successful anastomosis between the retinal and choroidal circulation in eyes with hemi-vein occlusions may reduce macular oedema and improve vision. Complications of the technique are significant and a randomized clinical trial is due to commence which may clarify the suitability of this treatment.