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Optic nerve sheath decompression for glaucomatous optic neuropathy with normal intraocular pressure
M B Wax1, D A Barrett, W M Hart
1Department of Ophthalmology and Visual Sciences, Washington University, School of Medicine, St Louis, Mo.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|September 1, 1993
Summary
Optic nerve sheath decompression offered temporary visual field improvement in some normal-pressure glaucoma patients. However, long-term benefits for this glaucoma treatment appear limited, with deterioration observed in some cases.
Area of Science:
- Ophthalmology
- Neurosurgery
Background:
- Normal-pressure glaucoma (NPG) is characterized by optic nerve damage and visual field loss despite normal intraocular pressure.
- Conventional therapies often fail to halt disease progression in NPG.
- Optic nerve sheath decompression (ONSD) is a surgical intervention explored for various optic neuropathies.
Observation:
- This study evaluated the therapeutic experience with ONSD in six patients (seven eyes) with NPG experiencing progressive visual field loss.
- Patients had no optic nerve head swelling but showed nerve fiber bundle damage.
- Follow-up ranged from 3 to 18 months, with regular visual field and acuity assessments.
Findings:
- Two of seven eyes showed initial improvement in visual fields and acuity post-ONSD.
- This improvement was transient, with visual fields deteriorating by 18 months in these two eyes.
- The remaining four patients experienced no significant change in visual fields or acuity during the follow-up period.
Implications:
- ONSD may provide transient benefits for visual function in select NPG patients.
- The long-term efficacy of ONSD for NPG with nerve fiber bundle damage appears limited.
- Further research is needed to determine the role of ONSD in managing progressive NPG.