Radial Optic Neurotomy Versus intravitreal Triamcinolon –
The ROVO Study
Simon Brunner (Vienna)
Background: Today`s “State of the art” treatments such as pharmaceutical treatments, panretinal
photocoagulation or grid lasercoagulation have so far not shown any beneficial effect on
visual acuity in patients with central retinal vein occlusion. Radial optic neurotomy (RON) is a
surgical procedure, performed after vitrectomy from a transvitreal approach, to decompress the
central vein occlusion via a radial incision on the nasal side of the optic nerve. So far no
prospective, randomised and placebo-controlled studies have been conducted.
Method: The ROVO study is a prospective, multicenter, placebocontrolled and randomised
study designed to evaluate the effect of radial optic neurotomy in central vein occlusion, versus
triamcinolone acetonide. 240 patients with a visual acuity < 0.5 Snellen will be randomised.
Patients are treated with either RON, or a single intravitreal injection of 4 mg triamcinolone acetonide, or a placebo treatment
- a “sham” injection of intravitreal triamcinolone. Patients will be examined regularly over a period of one year
Best corrected visual acuity for far and near, as well as clinical examinations, fluorescein- and indocyanine green
angiograms, optical coherence tomography, and perimetry, are performed pre- and postoperatively.
Results: The primary outcome variable is the change of best refracted visual acuity over one year. Changes in reading vision,
fundus perfusion and macular edema- dynamics will be evaluated, as well as all complications.
At the moment recruitment is ongoing in 6 out of 19 participating centres worldwide, in Europe, North and South America,
as well as Africa. 43 patients have been included so far and preliminary results are encouraging.
Conclusion: The results of our study will enable an objective analysis of all risks and benefits of these two new surgical
procedures available for CVO.