I read in one of the throwaways recently that a surgeon described some success creating retinal-choroidal anastomoses via a pars plana vitrectomy. He cuts through the vein to the choroid with an MVR blade, and demonstrated via flourescein that it worked, relieving venous congestion. This was attempted many years ago using laser, but was deemed a failure. Maybe this more invasive method would be worthwhile in poor prognosis cases.