Journal of Clinical and Experimental Ophthalmology
Open Access

Abstract

Outcomes of Optic Nerve Sheath Decompression for Visual Loss in Idiopathic Intracranial Hypertension

Nada Jirasková, Pavel Rozsíval, Alexander Stepanov, Vera Velika and Jan Lešták

Purpose: To report our experience with optic nerve sheath decompression (ONSD) for visual loss in idiopathic intracranial hypertension (IIH).
Methods: Six patients (7 eyes) with idiopathic intracranial hypertension and visual loss were involved. Five women and 1 man (mean age 42 years, ranged from 12 to 65 years) were operated at the Department of Ophthalmology, University Hospital, Hradec Králové. Surgeries were performed by a standard medial transconjunctival approach and the sheaths were cut by three incisions. We have not seen any serious intra and postoperative complications. Only one patient developed transient double vision after surgery.
Results: Visual functions improved in 5 patients. In one patient permanent visual loss with optic atrophy in both eyes occurred due to long-term duration of papilledema before referral to us.
Conclusions: On the basis of our results, we believe that ONSD is safe and effective treatment of patients with IIH in vision-threatening cases after thoroughly balanced assessment of possible risks and gains.