Optic nerve sheath fenestration in leukemic patients having increased intracranial pressure: a prospective clinical trial

Mohammed, Mai; Doheim, Mohamed Fahmy; Allam, Ibrahim Y

doi:10.1007/s10792-021-01887-x

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…The degree of papilloedema was rated according to criteria of Sinclair et al 36 or the disc appearances simply described. Of the 35 patients, 30 had primary PTC (IIH), 5 had secondary PTC, 3 due to malignant meningitis – 1 each had gastric cancer, 13 acute leukaemia 37 or lymphoma 38 and 2 due to venous sinus thrombosis 39 . Nine patients were excluded because reliable pre‐operative or post‐operative VF or VA results were unavailable or because they had had previous neurosurgery for IIH.…”

Section: Methodsmentioning

confidence: 99%

Optic nerve sheath fenestration for treating papilloedema in the era of cerebral venous sinus stenting

McCluskey

Lam

Ang

et al. 2023

Clinical Exper Ophthalmology

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Background Pseudotumour cerebri (PTC) is the syndrome of intracranial hypertension without intracranial mass or hydrocephalus and is the commonest cause of papilloedema seen in many eye clinics. In the last 10 years, we have increasingly used TSS in patients whose papilloedema was not well controlled with medical treatment and have done fewer ONSFs. Here, we review our experience at Royal Prince Alfred Hospital Sydney with ONSF in 35 patients over the period 2002–2021. Methods Retrospective case series of 35 patients, 30 of whom had primary PTC [i.e., idiopathic intracranial hypertension (IIH)] and 5 with secondary PTC. Results Eighteen patients had bilateral ONSF and 17 patients unilateral ONSF, in each case of the worse eye. Thirteen patients then underwent transverse sinus stenting (TSS), in each case following ONSF. The primary outcome measures were visual acuity (VA) and mean deviation (MD) on visual field (VF) testing. MD improved by 5 dB or more in 34 of 70 total eyes (48.6%); VA improved by 0.2 logMAR (two lines on Snellen chart) or more in 21 eyes (30%), and by both in 15 eyes (21.4%). Final MD was −10 dB or better in 38 eyes (54.3%); final VA was 0.3 (6/12) or better in 54 eyes (77.1%), and both in 39 eyes (55.7%). Conclusions The results confirm that ONSF can relieve papilloedoema in both eyes and improve both VF and VA, even in cases of fulminant PTC with severe acute visual impairment.

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Section: Methodsmentioning

confidence: 99%

Optic nerve sheath fenestration for treating papilloedema in the era of cerebral venous sinus stenting

McCluskey

Lam

Ang

et al. 2023

Clinical Exper Ophthalmology

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“…5 ONSF is considered beneficial for patients with IIH, including those in whom IIH is associated with proliferative diseases, such as leukaemia. 5,6…”

Section: Introductionmentioning

confidence: 99%

“…5 ONSF is considered beneficial for patients with IIH, including those in whom IIH is associated with proliferative diseases, such as leukaemia. 5,6 Open microscopic approaches (such as the medial transconjunctival approach), approaches through the upper eyelid, or lateral orbitotomy, have all been used in ONSF. 3,4 Most of these techniques involve controlled trauma and tissue disruption through medial rectus muscle disinsertion, eyelid transection, or bone removal.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic transconjunctival optic nerve sheath fenestration for progressive idiopathic visual field deficit: a case report

et al. 2021

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Intra-orbital optic nerve sheath fenestration (ONSF) is an effective option in patients with progressive vision loss due to idiopathic intracranial hypertension. Most proposed techniques involve surgical trauma and require disinsertion of the medial rectus muscle; thus, less invasive surgical procedures are needed. Here, a feasible and effective technique of endoscopic intra-orbital ONSF through a conjunctival incision is presented, in a patient with a progressively compromised visual field, papilloedema, and distended subarachnoid space around the optic nerves. The retrobulbar segment of the optic nerve was exposed for incision, avoiding manipulation of the lateral orbital rim bones and irritation of the ciliary microvessels and nerves. The patient regained the entire visual field. ONSF was safely and effectively performed endoscopically through a narrow corridor gained by brushing away the orbital fat with minimal traction on the medial rectus muscle. The small postoperative wound was associated with faster and easier convalescence, and less tissue trauma versus conventional open approaches.

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Sight-Threatening Pseudotumor Cerebri Due to Acute Promyelocytic Leukaemia Treated with Optic Nerve Sheath Fenestration

Littlewood,

Pepper,

Hickman

et al. 2024

Neuro-Ophthalmology

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Optic nerve sheath fenestration in leukemic patients having increased intracranial pressure: a prospective clinical trial

Cited by 3 publications

References 22 publications

Optic nerve sheath fenestration for treating papilloedema in the era of cerebral venous sinus stenting

Optic nerve sheath fenestration for treating papilloedema in the era of cerebral venous sinus stenting

Endoscopic transconjunctival optic nerve sheath fenestration for progressive idiopathic visual field deficit: a case report

Sight-Threatening Pseudotumor Cerebri Due to Acute Promyelocytic Leukaemia Treated with Optic Nerve Sheath Fenestration

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