Pediatric optic nerve sheath decompression.
OBJECTIVE
To review our experience with optic nerve sheath decompression for pediatric pseudotumor cerebri.


METHODS
Retrospective chart review.


METHODS
Seventeen eyes in 12 children younger than 16 years of age. All patients were either unresponsive or intolerant to medication. INTERVENTION, METHODS, OR TESTING: An optic nerve sheath fenestration was performed.


METHODS
Optic nerve appearance, visual acuity, color vision, and visual fields.


RESULTS
The average age at surgery was 10.1 years of age. The average follow-up was 39.6 months. Headache was the most common presenting symptom. All patients showed improvement in optic nerve edema. Visual acuity improved or stayed the same in all surgical eyes (P = 0.0078). One patient required a neurosurgical lumbar peritoneal shunt, and 2 patients required acetazolamide on the last follow-up appointment. No patient had postoperative infection, loss of vision, or strabismus develop. Five of the patients in this study required sheath decompression on the other eye.


CONCLUSIONS
Optic nerve sheath decompression in children is safe, and the results are similar to those obtained in adults. Close follow-up is required, because 5 of 12 patients in this study required a contralateral optic nerve sheath decompression.
Thuente
Daniel D
DD
Duke University Eye Center, Durham, North Carolina 27710, USA.
Buckley
Edward G
EG
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003118:Color Perception / Q000502:physiology; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D013508:Ophthalmologic Surgical Procedures; D009900:Optic Nerve / Q000601:surgery*; D010211:Papilledema / Q000601:surgery*; D011559:Pseudotumor Cerebri / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology