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Optic nerve sheath fenestration in cryptococcal meningitis

Tatyana Milman1, Neena Mirani, Roger E Turbin

  • 1Ophthalmology Department, Institute of Ophthalmology and Visual Science.

Clinical Ophthalmology (Auckland, N.Z.)
|August 12, 2009
PubMed

Insights

A patient with acquired immunodeficiency syndrome (AIDS) experienced vision loss from cryptococcal meningitis. Optic nerve sheath fenestration successfully restored vision by relieving intracranial pressure.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Cryptococcal meningitis can cause increased intracranial pressure.
  • Increased intracranial pressure may lead to papilledema and visual impairment.

Observation:

  • A patient with acquired immunodeficiency syndrome (AIDS) presented with cryptococcal meningitis, papilledema, and severe vision loss.
  • Medical management failed to improve the patient's visual acuity.

Findings:

  • Bilateral optic nerve sheath fenestration was performed.
  • The procedure resulted in significant visual improvement and resolution of papilledema.
  • Histopathology confirmed fungal presence within the optic nerve sheath.

Implications:

  • Optic nerve sheath fenestration can be a viable treatment for visual loss due to high intracranial pressure in cryptococcal meningitis.
  • This surgical intervention may be effective even with direct fungal involvement of the optic nerve sheath.
Keywords:
cryptococcalfenestrationmeningitisoptic nerve sheath

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