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Modified optic nerve decompression in patients with functioning lumboperitoneal shunts and progressive visual loss.

S E Kelman1, R C Sergott, G A Cioffi

  • 1University of Maryland, Department of Ophthalmology, Baltimore 21201.

Ophthalmology
|September 1, 1991
PubMed
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Modified optic nerve sheath decompression improved vision in patients with pseudotumor cerebri and papilledema, even with existing shunts. This procedure releases cerebrospinal fluid pressure, halting and reversing vision loss.

Area of Science:

  • Ophthalmology
  • Neurosurgery
  • Neurology

Background:

  • Chronic papilledema associated with pseudotumor cerebri can lead to irreversible visual impairment.
  • Lumboperitoneal shunts are used to manage intracranial pressure but may not always prevent visual deterioration.

Purpose of the Study:

  • To evaluate the efficacy of modified optic nerve sheath decompression in patients with pseudotumor cerebri experiencing progressive visual loss despite functioning lumboperitoneal shunts.

Main Methods:

  • A cohort of 12 patients (16 operations) with pseudotumor cerebri, papilledema, and visual loss underwent modified optic nerve sheath decompression.
  • The study monitored visual function following the surgical intervention.

Main Results:

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  • All patients who underwent the procedure demonstrated improvement in visual function.
  • Optic nerve sheath decompression was effective in halting and reversing visual loss.

    • Conclusions:

    • Modified optic nerve sheath decompression is a viable surgical option for managing progressive visual loss in pseudotumor cerebri patients with chronic papilledema.
    • The procedure alleviates localized cerebrospinal fluid pressure around the optic nerve, thereby preserving and restoring vision.