Visual function following neurosurgical optic nerve decompression for compressive optic neuropathy

Sleep, Tamsin; Hodgkins, P R; Honeybul, Stephen; Neil‐Dwyer, G.; Lang, Dorothy; Evans, B.T.

doi:10.1038/sj.eye.6700439

Cited by 34 publications

(15 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite wide variation in the timing from the onset of signs/symptoms to presentation and treatment, all patients demonstrated benefit in terms of their visual outcomes. This coincides with other series (open, transcranial) 22,23 that have noted a poor correlation between duration of symptoms before intervention and visual outcomes following decompression. Perhaps a better predictor of success may be OCT data, specifically retinal nerve fiber layer thickness as some have suggested.…”

Section: Discussionsupporting

confidence: 90%

Endoscopic Endonasal Optic Nerve Decompression for Fibrous Dysplasia

et al. 2016

View full text Add to dashboard Cite

Objective?To evaluate visual outcomes and potential complications for optic nerve decompression using an endoscopic endonasal approach (EEA) for fibrous dysplasia. Design?Retrospective chart review of patients with fibrous dysplasia causing extrinsic compression of the canalicular segment of the optic nerve that underwent an endoscopic endonasal optic nerve decompression at the University of Pittsburgh Medical Center from 2010 to 2013. Main Outcome Measures?The primary outcome measure assessed was best-corrected visual acuity (BCVA) with secondary outcomes, including visual field testing, color vision, and complications associated with the intervention. Results?A total of four patients and five optic nerves were decompressed via an EEA. All patients were symptomatic preoperatively and had objective findings compatible with compressive optic neuropathy: decreased visual acuity was noted preoperatively in three patients while the remaining patient demonstrated an afferent pupillary defect. BCVA improved in all patients postoperatively. No major complications were identified. Conclusion?EEA for optic nerve decompression appears to be a safe and effective treatment for patients with compressive optic neuropathy secondary to fibrous dysplasia. Further studies are required to identify selection criteria for an open versus an endoscopic approach.

show abstract

Section: Discussionsupporting

confidence: 90%

Endoscopic Endonasal Optic Nerve Decompression for Fibrous Dysplasia

et al. 2016

View full text Add to dashboard Cite

show abstract

“…We could not find a correlation between the latency and the visual outcome (P=0.046), this is probably due to small group of patients with varying pathology which supports similar results observed by Sleep et al; [8].…”

Section: Correlation Of Latency With Visual Outcomesupporting

confidence: 89%

Visual Outcome Following Endoscopic Optic Canal Decompression in Compressive and Traumatic Optic Neuropathy- A Prospective Observational Study

S¹,

Sumathi²,

Ariga³

et al. 2016

SJAMS

View full text Add to dashboard Cite

Aim of the study is to assess the effect of Latency (Interval between onset and treatment), Underlying pathology and Pre-operative vision, on the visual outcome in case of Compressive Optic Neuropathy and Latency (Interval between onset and treatment), Intra operative findings and Pre-operative vision, on the visual outcome in case of Traumatic Optic Neuropathy. This study was conducted in the ENT Department along with the ophthalmology department at Sundaram Medical Foundation, Chennai, 160 bedded community based hospital. Prospective observational study conducted from July 2007 to July 2009. This prospective observational clinical study was done to assess the visual outcome following endoscopic optic canal decompression among 24 patients (14 traumatic and 10 compressive) at our institution, who were followed up for 1 month after surgery. Patients were included as per inclusion criteria formulated for this study & were analyzed with respect to their pre-operative & post-operative vision using visual analog score. The data was analyzed in "SPSS10 for Windows (Statistical Package for Social Sciences)" software. The accuracy and the other characteristics are determined by its independent comparison with its "Gold standard test" by constructing 2x2 tables. Visual improvement was assessed using Log MAR score and recorded in the first postoperative day, 1 week later and at the end of 1 month. From the result it was concluded that, in compressive optic neuropathy, latency was not a significant factor to influence the visual outcome. Pathology and pre-operative vision were found to be contributory factors on visual improvement following endoscopic optic canal decompression. In traumatic optic neuropathy, latency and pre-operative vision were found to be contributory factors on visual improvement following endoscopic optic canal decompression. Type of intra-operative finding was not a significant factor to influence the visual outcome. The observations & results of our study of endoscopic optic canal decompression are in comparison to similar studies reported in recent world literature.

show abstract

“…The specific approach assessed varied. Two studies 57,86 assessed anterolateral versus subfrontal approach. In this small group, the combined odds of improvement was not significant; the anterolateral versus subfrontal approach was 2.10 (95% CI ¼ 0.84 to 5.27).…”

Section: Approachmentioning

confidence: 99%

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

2012

View full text Add to dashboard Cite

Objectives?Surgical optic nerve decompression for chronic compressive neuropathy results in variable success of vision improvement. We sought to determine the effects of various factors using meta-analysis of available literature. Design?Systematic review of MEDLINE databases for the period 1990 to 2010. Setting?Academic research center. Participants?Studies reporting patients with vision loss from chronic compressive neuropathy undergoing surgery. Main outcome measures?Vision outcome reported by each study. Odds ratios (ORs) and 95% confidence intervals (CIs) for predictor variables were calculated. Overall odds ratios were then calculated for each factor, adjusting for inter study heterogeneity. Results?Seventy-six studies were identified. Factors with a significant odds of improvement were: less severe vision loss (OR 2.31[95% CI?=?1.76 to 3.04]), no disc atrophy (OR 2.60 [95% CI?=?1.17 to 5.81]), smaller size (OR 1.82 [95% CI?=?1.22 to 2.73]), primary tumor resection (not recurrent) (OR 3.08 [95% CI?=?1.84 to 5.14]), no cavernous sinus extension (OR 1.88 [95% CI?=?1.03 to 3.43]), soft consistency (OR 4.91 [95% CI?=?2.27 to 10.63]), presence of arachnoid plane (OR 5.60 [95% CI?=?2.08 to 15.07]), and more extensive resection (OR 0.61 [95% CI?=?0.4 to 0.93]). Conclusions?Ophthalmologic factors and factors directly related to the lesion are most important in determining vision outcome. The decision to perform optic nerve decompression for vision loss should be made based on careful examination of the patient and realistic discussion regarding the probability of improvement.

show abstract

Visual function following neurosurgical optic nerve decompression for compressive optic neuropathy

Cited by 34 publications

References 9 publications

Endoscopic Endonasal Optic Nerve Decompression for Fibrous Dysplasia

Endoscopic Endonasal Optic Nerve Decompression for Fibrous Dysplasia

Visual Outcome Following Endoscopic Optic Canal Decompression in Compressive and Traumatic Optic Neuropathy- A Prospective Observational Study

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

Contact Info

Product

Resources

About