Predictive Factors for Vision Recovery after Optic Nerve Decompression for Chronic Compressive Neuropathy: Systematic Review and Meta-Analysis

Stippler, Martina; Morley, Sarah; Myers, Orrin

doi:10.1055/s-2011-1274186

Cited by 5 publications

(9 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Still, impressive visual improvement has been reported following surgery of some patients with signs of chronic optic nerve compression. 41,64 On the other hand, patient 1 presented with symptoms following her second childbirth, but the presence of optic disc changes and the behavior of these tumors suggest that a long-standing asymptomatic ONSM underwent accelerated growth during pregnancy. Based on the experience with this cohort, and a review of the outcomes yielded by current treatment options, the surgical decompressive techniques could be a feasible alternative in the management of symptomatic patients with a suspected primary ONSM.…”

Section: Discussionmentioning

confidence: 99%

The Role of Endonasal Endoscopic Optic Nerve Decompression as the Initial Management of Primary Optic Nerve Sheath Meningiomas

et al. 2019

View full text Add to dashboard Cite

Background The management of optic nerve sheath meningiomas (ONSMs) remains controversial. Surgical decompression through traditional resective techniques has been associated with significant morbidity. While radiation therapy, the current modality of choice is not exempt of risks.Transnasal endoscopic optic nerve decompression (EOND) offers a direct route to the orbit, optic canal, and orbital apex, providing a minimally invasive alternative. Objective The main objective of this article is to assess EOND as the initial management of symptomatic patients with primary ONSM. Methods Patients with ONSMs without a history of radiotherapy who underwent EOND were retrospectively reviewed. Postoperative imaging, duration of follow-up, and visual outcomes at the last ophthalmology visit were assessed. Results Four women (age range 25–63 years) with primary ONSMs that underwent EOND were identified. All patients displayed subjective and objective baseline signs of vision loss. Additionally, baseline proptosis, diplopia, optic nerve atrophy, and ocular pain were identified. In none of the cases, the optic nerve sheath was breached.Following EOND, all patients deferred treatment with adjuvant radiotherapy. At a mean postoperative follow-up of 14 months, all patients were clinically stable without evidence of disease progression on imaging or physical examination. At last ophthalmologic evaluation, three out of four showed objective improvements from baseline visual acuity and visual field (remaining patient had baseline optic nerve atrophy). Conclusion These results suggest that EOND could be a viable initial treatment modality of selected primary ONSM cases. Further studies are warranted to determine long-term efficacy and its role in a stepwise progression of management, preceding radiotherapy.

show abstract

Section: Discussionmentioning

confidence: 99%

The Role of Endonasal Endoscopic Optic Nerve Decompression as the Initial Management of Primary Optic Nerve Sheath Meningiomas

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Positive surgical factors included primary resection, a soft tumor consistency, a clear dissection plane, absence of tumor in the cavernous sinus, and a complete tumor excision. 25 Age and gender were not shown to have predictive value in determining visual outcomes. The duration of symptoms was shown to play a role in visual outcomes, that is, the longer the duration of symptoms, the greater the chance of poor postoperative vision.…”

Section: Discussionmentioning

confidence: 88%

“…However, if vision is on the poorer side preoperatively, there is a small chance of improvement. 25 Shrivastava et al reported an improvement in visual acuity in only 28% and vision remained unchanged in 72% of cases when employing optic nerve decompression for sphenoid wing meningioma using an open surgical approach. 18 On review of the literature, there is a wide range of improvement in visual outcomes in patients with sphenoid wing meningioma using an open craniotomy approach, that is, 28 to 70 %.…”

Section: Discussionmentioning

confidence: 99%

Transorbital Endoscopic Surgery for Sphenoid Wing Meningioma: Long-Term Outcomes and Surgical Technique

Gonçalves

Lubbe

2020

J Neurol Surg B Skull Base

View full text Add to dashboard Cite

Sphenoid wing meningiomas are benign tumors that can result in proptosis, visual impairment, and pain. Traditional open surgical approaches are associated with significant morbidity. Transorbital endoscopic surgery has been developed as a minimally invasive approach to gain access to these tumors and address the main presenting symptoms. Case series reporting transorbital endoscopic resection of sphenoid wing meningiomas using combined endonasal, pre-caruncular, and extended superior eyelid approaches have demonstrated stable and/or improved short- and medium-term visual outcomes. Earlier medial optic nerve decompression appears to result in more favorable long-term visual outcomes. Transorbital endoscopic surgery therefore represents an emerging minimally invasive alternative to deal with these challenging lesions.

show abstract

“…For patients with severe visual loss, we performed total resection of the intraorbital and intracanalicular optic nerve together with the tumor. Cristante et al (16) have suggested that patients with poor VA are unlikely to benefit from debulking surgery because the visual outcome is correlated with preoperative vision loss; thus, the worse the preoperative vision, the less likely that the vision will improve postoperatively (17). In addition, studies have shown that postoperative improvements in vision are correlated with the duration of the preoperative symptoms (18), and that improved postoperative vision was only seen in patients who had experienced a rapid decline in vision (<5 months before surgery) (19).…”

Section: Discussionmentioning

confidence: 99%

Combined endoscopic transethmoid and transconjunctival en bloc resection of optic nerve tumors in patients lacking functional vision

Shi

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

BackgroundSurgical treatment of optic nerve tumors is challenging. The study’s objective was to evaluate the efficacy of a combined endoscopic transethmoid and transconjunctival approach in patients without functional vision.DesignA retrospective, noncomparative case series.MethodsRetrospective data were collected from all patients who had undergone tumor resection using this approach at the authors’ institution between 2015 and 2021. Preoperative assessments included magnetic resonance imaging and ophthalmological examinations, and re-assessments were conducted three months after surgery and regularly during the follow-up period.ResultsSeventeen patients, mean age 35 ± 19.0 years, were enrolled. Of these, 64.7% presented with visual acuity (VA) of light perception or no light perception. Gross total resection was realized in all patients. The average decline in exophthalmos was 3.63 ± 1.93 mm. Tumor histopathological analysis identified 12 optic nerve sheath meningiomas and 5 optic gliomas. The mean follow-up time was 30 months during which there was no local recurrence in any of the patients.ConclusionsThe combined endoscopic transethmoid and transconjunctival approach offers an additional choice for accessing optic nerve tumors. The procedure is both safe and effective and provides an alternative transcranial route to the orbit.

show abstract

Predictive Factors for Vision Recovery after Optic Nerve Decompression for Chronic Compressive Neuropathy: Systematic Review and Meta-Analysis

Cited by 5 publications

References 21 publications

The Role of Endonasal Endoscopic Optic Nerve Decompression as the Initial Management of Primary Optic Nerve Sheath Meningiomas

The Role of Endonasal Endoscopic Optic Nerve Decompression as the Initial Management of Primary Optic Nerve Sheath Meningiomas

Transorbital Endoscopic Surgery for Sphenoid Wing Meningioma: Long-Term Outcomes and Surgical Technique

Combined endoscopic transethmoid and transconjunctival en bloc resection of optic nerve tumors in patients lacking functional vision

Contact Info

Product

Resources

About