This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Robert C. Sergott, MD; Peter J. Savino, MD; Thomas M. Bosley, MD

Arch Ophthalmol. 1988;106(10):1384-1390.

Abstract
• Twenty-three patients with chronic papilledema associated with pseudotumor cerebri underwent "modified" optic nerve sheath decompression for treatment of visual acuity and visual field loss. Instead of removing a single, rectangular section of optic nerve meninges, the operation was modified by making at least three longitudinal incisions in the sheath and then lysing arachnoid adhesions with a tenotomy hook. Twenty-one of the 23 patients demonstrated improved visual function after the initial surgery for a mean (±SD) follow-up of 21.5 ± 12.3 months (median, 25 months; range, three to 45 months) without reoperation or reinstitution or oral corticosteroid and diuretic therapies. The two patients failing to improve after the first surgical procedure initially had a single meningeal window created and subsequently improved following reoperation with the modified procedure. Twelve of 21 patients with bilateral visual loss had improved visual function bilaterally after unilateral surgery. Six of the 21 patients needed bilateral surgery, and the other three had minor visual field defects in the second eye not severe enough to warrant surgery. Preoperative optic disc pallor did not predict a poor postoperative result. Optic nerve surgery improved the visual function in six patients who had failed to recover vision after one or more lumbar-peritoneal shunts.

Author Affiliations
From the Neuro-Ophthalmology Service, Wills Eye Hospital, Philadelphia.

Footnotes
Accepted for publication June 7, 1988.

Reprint requests to Neuro-Ophthalmology Service, Wills Eye Hospital, 9th and Walnut streets, Philadelphia, PA 19107 (Dr Sergott).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Pediatric Idiopathic Intracranial Hypertension: A Review
Mercille and Ospina
Pediatr. Rev. 2007;28:e77-e86.
FULL TEXT  

Idiopathic intracranial hypertension and visual function
Acheson
Br Med Bull 2007;0:ldl019v1-12.
ABSTRACT | FULL TEXT  

Macroglial Alterations after Isolated Optic Nerve Sheath Fenestration in Rabbit
Villain et al.
IOVS 2002;43:120-128.
ABSTRACT | FULL TEXT  

Ovarian hyperstimulation syndrome and benign intracranial hypertension in pregnancy after in-vitro fertilization and embryo transfer: Case report
Lesny et al.
Hum Reprod 1999;14:1953-1955.
ABSTRACT | FULL TEXT  

Diagnosis and management of benign intracranial hypertension
Soler et al.
Arch. Dis. Child. 1998;78:89-94.
FULL TEXT  

Effect of mitomycin C on the optic nerve in rabbits
Mietz et al.
Br J Ophthalmol 1997;81:584-589.
ABSTRACT | FULL TEXT  

Optic Nerve Sheath Decompression for Glaucomatous Optic Neuropathy With Normal Intraocular Pressure
Wax et al.
Arch Ophthalmol 1993;111:1219-1228.
ABSTRACT  

Optic Nerve Sheath Fenestration Through a Lateral Canthotomy Incision
Kersten and Kulwin
Arch Ophthalmol 1993;111:870-874.
ABSTRACT  

Long-term Effectiveness of Optic Nerve Sheath Decompression for Pseudotumor Cerebri
Spoor and McHenry
Arch Ophthalmol 1993;111:632-635.
ABSTRACT  

Optic Nerve Sheath Fenestration for Treatment of Progressive Ischemic Optic Neuropathy: Results in 26 Patients
Jablons et al.
Arch Ophthalmol 1993;111:84-87.
ABSTRACT  

Neuroimaging of the Optic Nerve After Fenestration for Management of Pseudotumor Cerebri
Hamed et al.
Arch Ophthalmol 1992;110:636-639.
ABSTRACT  

Mechanism of Optic Nerve Sheath Fenestration
Bazarian and Burde
Arch Ophthalmol 1991;109:613-613.
ABSTRACT  

Optic Nerve Sheath Decompression for Nonarteritic Ischemic Optic Neuropathy Improves Multiple Visual Function Measurements
Kelman and Elman
Arch Ophthalmol 1991;109:667-671.
ABSTRACT  

Idiopathic Intracranial Hypertension Without Papilledema
Marcelis and Silberstein
Arch Neurol 1991;48:392-399.
ABSTRACT  

A Model for the Mechanism of Optic Nerve Sheath Fenestration
Seiff and Shah
Arch Ophthalmol 1990;108:1326-1329.
ABSTRACT  

Optic Nerve Decompression May Improve the Progressive Form of Nonarteritic Ischemic Optic Neuropathy
Sergott et al.
Arch Ophthalmol 1989;107:1743-1754.
ABSTRACT  

The Rational Management of Idiopathic Intracranial Hypertension
Corbett and Thompson
Arch Neurol 1989;46:1049-1051.
ABSTRACT  

Acute Retinal Necrosis Neuropathy: Clinical Profile and Surgical Therapy
Sergott et al.
Arch Ophthalmol 1989;107:692-696.
ABSTRACT  

Evaluation of the Relative Afferent Pupillary Defect in Pseudotumor Cerebri in Regard to Surgical Intervention
Frenkel
Arch Ophthalmol 1989;107:634-635.
ABSTRACT  

Optic Nerve Sheath Decompression: How Does It Work? Has Its Time Come?
Keltner
Arch Ophthalmol 1988;106:1365-1369.
ABSTRACT