title: Optic nerve decompression may improve the progressive form of nonarteritic ischemic optic neuropathy.
abstract: Optic nerve sheath decompression surgery improved visual function for 12 of 14 patients with progressive nonarteritic ischemic optic neuropathy (NAION). Visual recovery was maintained in all patients during a follow-up period of 6 to 18 months (average, 11 months). Seven patients had experienced a previous NAION in the eye that was not operated on that did not improve spontaneously. Surprisingly, 2 of these 7 eyes with long-standing decreased vision demonstrated some visual improvement after surgery on the contralateral, acutely affected eye. Spontaneous visual improvement did not occur in an age- and sex-matched control group of 12 patients with similar entry-level visual acuity and field loss. Only 1 of 3 patients with sudden, nonprogressive visual loss secondary to NAION improved after surgery. In a control group with nonprogressive NAION, 2 of 15 eyes (14 patients) demonstrated spontaneous improvement. Optic nerve sheath decompression improves visual loss due to progressive NAION, a disorder without any previously effective therapy. However, for acute, nonprogressive NAION, surgery for a small number of patients did not improve the natural history of the disease.
authors.affiliation: Neuro-Ophthalmology Service, Wills Eye Hospital, Philadelphia, Pa 19107.
authors.forename: R C
authors.initials: RC
authors.lastname: Sergott
authors.forename: M S
authors.initials: MS
authors.lastname: Cohen
authors.forename: T M
authors.initials: TM
authors.lastname: Bosley
authors.forename: P J
authors.initials: PJ
authors.lastname: Savino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000473:pathology*; D009900:Optic Nerve / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D009901:Optic Nerve Diseases / Q000473:pathology / Q000601:surgery*; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields