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Pseudotumor cerebri and optic nerve sheath decompression.
1Oklahoma University Health Sciences Center, Dean A. McGee Eye Institute, Oklahoma City, Oklahoma 73104-5065, USA.
Ophthalmology
|October 3, 2000
Summary
Optic nerve sheath decompression effectively restored or improved vision in 94% of patients with pseudotumor cerebri. This safe surgical option offers a viable treatment for vision loss resistant to medical therapy.
Area of Science:
- Ophthalmology
- Neurosurgery
- Neurology
Background:
- Pseudotumor cerebri (idiopathic intracranial hypertension) can cause progressive visual loss.
- Medical management is often insufficient for patients with significant visual impairment.
Purpose of the Study:
- To evaluate the efficacy and safety of optic nerve sheath decompression (ONSD) for pseudotumor cerebri.
- To establish a treatment algorithm based on study data.
Main Methods:
- Retrospective, noncomparative, interventional case series.
- 158 eyes in 86 patients with pseudotumor cerebri underwent ONSD.
- Outcomes assessed included visual acuity, visual fields, and surgical complications.
Main Results:
- Visual acuity improved or stabilized in 94% of eyes (148/158).
- Visual fields improved or stabilized in 88% of tested eyes (71/81).
- Complications were mostly transient (39/86 patients); only one eye experienced permanent severe visual loss.
Conclusions:
- Optic nerve sheath decompression is a safe and effective treatment for pseudotumor cerebri with visual loss.
- ONSD stabilizes visual acuity and visual fields in patients unresponsive to medical therapy.