[Indications and technique for transconjunctival optic nerve sheath fenestration : Video article]

Area of Science:

• Ophthalmology
• Neurosurgery
• Medical Science

Background:

• Pseudotumor cerebri syndrome (PTCS) often requires intervention to manage increased intracranial pressure.
• Ventricular shunts are a common treatment, but optic nerve sheath fenestration (ONSF) is considered when visual symptoms dominate.

Purpose of the Study:

• To review the indications, surgical technique, and outcomes of ONSF for PTCS.
• To compare ONSF with alternative treatments for PTCS-related vision loss.

Main Methods:

• Systematic literature search and analysis of surgical cases.
• Documentation and description of the medial transconjunctival orbitotomy technique for ONSF.
• Review of surgical microscope use with confocal illumination for optic nerve visualization.

Main Results:

• Transconjunctival ONSF is a safe procedure for reducing visual loss in PTCS.
• ONSF can be an effective alternative to shunts or venous stents in select patients.

Conclusions:

• ONSF provides a valuable option for preserving vision in PTCS patients with predominant ophthalmological symptoms.
• This minimally invasive approach offers a viable alternative to more invasive procedures.