Outcomes of surgically treated rhinogenic optic neuropathy

Nakaya, Kazuhiro; Oshima, Takeshi; Ikeda, Ryoukichi; Hidaka, Hiroshi; Kobayashi, Toshimitsu

doi:10.3109/00016489.2011.557837

Cited by 9 publications

(21 citation statements)

References 19 publications

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“…The clinical symptoms of rhinogenic optic neuropathy are various and include visual disturbance, central scotoma, oculomotor palsy, and abducent palsy [2]. To treat the condition, the cyst is marsupialized using endoscopic sinus surgery in the sphenoid sinus or the ethmoid sinus, and communication with the nasal cavity is obtained [3–6].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Factors for Postoperative Visual Acuity in Patients with Rhinogenic Optic Neuropathy

Otsuka

Yunoki

Ozaki

et al. 2019

Journal of Ophthalmology

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Purpose To examine the prognostic factors related to postoperative visual acuity in patients with rhinogenic optic neuropathy. Study Design Retrospective observational study. Materials and Methods We retrospectively studied the medical records for 15 eyes of 15 patients who underwent surgery for the treatment of rhinogenic optic neuropathy between 31 January 2010 and 30 April 2018 at Toyama University Hospital. The patient age, sex, preoperative and postoperative visual acuity, duration from visual deficit to surgery, use of steroids, type of rhinogenic optic neuropathy, and the part of sinus lesion were analyzed. We also examined postoperative visual acuity for patients whose preoperative visual acuity was less than light perception. Results The type of optic neuropathy was sinusitis in 7 cases, mucocele in 5 cases, and pyocele in 3 cases. Visual acuity was improved in 9 cases and deteriorated or unchanged in 6 cases. Patients in the improvement group were significantly younger than those in the nonimprovement group (p=0.01). In univariate regression analysis, preoperative visual acuity and type of optic neuropathy significantly related to postoperative visual acuity. Finally, 4 of the 15 cases (27%) had preoperative visual acuity less than light perception, but there was an improvement in postoperative visual acuity in 2 of 4 cases (50%). Conclusions Preoperative visual acuity is the predictive factor for postoperative visual acuity in patients with rhinogenic optic neuropathy, but even if the preoperative visual acuity is less than light perception, it can be improved by surgical treatment.

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Section: Introductionmentioning

confidence: 99%

Prognostic Factors for Postoperative Visual Acuity in Patients with Rhinogenic Optic Neuropathy

Otsuka

Yunoki

Ozaki

et al. 2019

Journal of Ophthalmology

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“…Rhinogenic optic neuropathy is characterized by optic nerve damage secondary to the sinonasal lesion, and includes various sinonasal diseases such as sinusitis, mucocele, and sinus surgery,[ 1 ] with the main mechanism being compression and inflammatory changes. [ 2 ] In addition to optic neuropathy, orbital invasion is a common manifestation with ocular findings such as lid edema, blepharoptosis, conjunctival chemosis, conjunctival injection, diplopia, limitation of ocular motility, globe displacement, epiphora, anisocoria, eye pain, and photophobia.…”

Section: Discussionmentioning

confidence: 99%

“…The efficacy of steroid therapy for rhinogenic optic neuropathy has not been elucidated, possibly due to the limited number of cases. [ 1 ] Surgical intervention in the form of orbital or optic nerve decompression accompanied by systemic steroids resulted in favorable visual outcome;[ 1 4 ] however, poor prognosis was still mentioned in case reports of sphenoid sinus mucocele and eosinophilic chronic rhinosinusitis. [ 2 ] Preoperative visual acuity tended to correlate with prognosis; therefore, patients with severely impaired vision should be given more attention and treated aggressively.…”

Section: Discussionmentioning

confidence: 99%

“…No clear consensus exists regarding treatment for SNUC, but a combination of operation, chemotherapy, and radiotherapy may be suggested. [ 1 2 5 11 ]…”

Section: Discussionmentioning

confidence: 99%

“…Optic neuropathy is characterized by damage to the optic nerve caused by compression, inflammation, infiltration, ischemic change, and glaucoma, which may lead to the different severity of visual impairment, even visual loss. [ 1 ] Optic neuropathy caused by lesions from the nasal or paranasal sinus is called rhinogenic optic neuropathy. Herein, we report a case of rhinogenic optic neuropathy resulting from sinonasal carcinoma, presenting with the sequential bilateral visual loss.…”

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confidence: 99%

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Sinonasal carcinoma presenting as chronic sinusitis and sequential bilateral visual loss

Chiang

Chen

Huang

2015

Indian J Ophthalmol

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Sinonasal undifferentiated carcinoma-related rhinogenic optic neuropathy is rare and may lead to visual loss. To the best of our knowledge, this is the first report of bilateral sequential visual loss induced by this etiology. It is important to differentiate between chronic sinusitis and malignancy on the basis of specific findings on magnetic resonance images. Surgical decompression with multidisciplinary therapy, including steroids, chemotherapy, and radiotherapy, is indicated. However, no visual improvement was noted in this case, emphasizing the rapid disease progression and importance of early diagnosis and treatment.

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