ABSTRACT
Creation of an anastomosis between a retinal vein and the underlying choroid may bypass the occluded segment of the retinal vein, so that the retinal venous circulation can drain directly into the choroid. The creation of a chorio-retinal anastomosis may be accomplished using either laser or surgery. S. Fekrat and de Juan described transvitreal venipuncture, a vitreoretinal surgical technique to create a chorioretinal anastomosis in an eye with ischemic central retinal vein occlusion (CRVO). Histopathologic evaluation of eyes damaged and enucleated because of CRVO often demonstrates an occlusion at or just behind the level of the lamina cribrosa. Intravitreal injection of thrombolytics for CRVO appears to be simple and safe, and may have some beneficial effects with regard to visual outcome. Direct intraluminal delivery of the thrombolytic agent by means of retinal vein cannulation is considered the treatment of choice for cases of CRVO, as it has many theoretical advantages.
