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I read with interest the article by García-Arumí et al.¹ Based on an uncontrolled study of radial optic neurotomy in 14 patients with nonischemic central retinal vein occlusion (CRVO), they conclude that radial optic neurotomy "improves or at least stabilizes the course of severe" CRVO because of "decompression" and "by inducing new chorioretinal shunts."

From prospective studies of more than 600 patients with nonischemic CRVO during 30 years and from basic, experimental, and clinical research on the optic nerve and CRVO, I find their conclusions misleading and the study flawed. For example:

(1) There is no information about the criteria used to define nonischemic CRVO. The common criterion of 10-disc diameter retinal capillary nonperfusion to differentiate ischemic from nonischemic CRVO is an invalid criterion.²

(2) The central retinal vein (CRV) lies temporal to the central retinal artery in the optic nerve, both enclosed by a common fibrous tissue capsule. Thus, . . . [Full Text of this Article]

Sohan Singh Hayreh, MD, PhD, DSc, FRCOphth

Correspondence: Dr Hayreh, Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242-1091 (sohan-hayreh@uiowa.edu).

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