[Intra-orbital decompression of the optic nerve by opening the peri-optic meninges in the treatment of severe optic neuropathies complicating benign intracranial hypertension].
Papilledema from benign intracranial hypertension can cause severe loss of visual acuity and visual field, with an optic neuropathy. We report a study of 5 patients with benign intracranial hypertension, and severe visual loss (visual field loss and visual acuity reduced to 1/10 or less) not improved by medical therapy (acetazolamide). We performed unilateral orbital decompression of the optic nerve sheath. No major operative complication was noted. Follow-up ranged from 11 months to 23 months, with an average of sixteen months. Visual function improvement was noted within 3 months after operation in 4 patients (for 2 eyes on the surgical side improvement of 2/10 and 5/10, for 3 eyes on the opposite surgical side average improvement of 4.6/10). The other patient showed improvement, but no significant. Optic nerve sheath decompression in benign intracranial hypertension seems to be a safe procedure and a therapeutic option in the management of raised intracranial pressure complicated by optic neuropathy with severe visual loss.
Villain
M
M
Service d'Ophtalmologie, Hôpital Gui de Chauliac, CHU, Montpellier.
Candon
E
E
Adenis
J P
JP
Arnaud
B
B
Frerebeau
P
P
D000086:Acetazolamide / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D019299:Decompression, Surgical / Q000379:methods*; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008578:Meninges / Q000601:surgery*; D008875:Middle Aged; D009900:Optic Nerve / Q000601:surgery*; D010211:Papilledema / Q000188:drug therapy / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D011559:Pseudotumor Cerebri / Q000150:complications*; D016896:Treatment Outcome; D014792:Visual Acuity; D014794:Visual Fields
D004232:Diuretics; D000086:Acetazolamide
Décompression intra-orbitaire du nerf optique par ouverture des méninges péri-optiques dans le traitement des neuropathies optiques sévères compliquant une hypertension intracrânienne bénigne.