Pseudotumor cerebri and optic nerve sheath decompression.
OBJECTIVE
To determine the efficacy and safety of optic nerve sheath decompression in a large population of patients with pseudotumor cerebri with visual loss despite medical treatment and to suggest a treatment algorithm on the basis of these data.


METHODS
Retrospective, noncomparative, interventional case series.


METHODS
One hundred fifty-eight eyes in 86 patients with pseudotumor cerebri.


METHODS
Optic nerve sheath decompression.


METHODS
Visual acuity, visual fields, and surgical complications.


RESULTS
After optic nerve sheath decompression for pseudotumor cerebri, visual acuity stabilized or improved in 148 of 158 (94%) eyes, and visual fields stabilized or improved in 71 of 81 (88%) eyes. Surgical complications, most of which were transient and benign, were seen in 39 of 86 patients. Only one eye in one patient had permanent severe visual loss secondary to an operative complication.


CONCLUSIONS
In patients with pseudotumor cerebri with progressive visual loss despite maximum medical therapy, optic nerve sheath decompression is a safe and effective means of stabilizing visual acuity and the visual fields of those tested.
Banta
J T
JT
Oklahoma University Health Sciences Center, Dean A. McGee Eye Institute, Oklahoma City, Oklahoma 73104-5065, USA.
Farris
B K
BK
D000328:Adult; D000465:Algorithms; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D009900:Optic Nerve / Q000601:surgery*; D017410:Practice Guidelines as Topic; D011559:Pseudotumor Cerebri / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity; D014794:Visual Fields