Predicting visual recovery following optic nerve decompression for chronic optic neuropathy

Miller, Neil R.

doi:10.1007/s00701-009-0404-4

Cited by 3 publications

(2 citation statements)

References 5 publications

(6 reference statements)

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“…Perhaps a better predictor of success may be OCT data, specifically retinal nerve fiber layer thickness as some have suggested. [24][25][26] While this study demonstrates a benefit of endoscopic decompression in select patients, there are several limitations. First, it is a small study population.…”

Section: Discussionmentioning

confidence: 88%

Endoscopic Endonasal Optic Nerve Decompression for Fibrous Dysplasia

et al. 2016

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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.

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Section: Discussionmentioning

confidence: 88%

Endoscopic Endonasal Optic Nerve Decompression for Fibrous Dysplasia

et al. 2016

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“…The surgical literature is inconsistent with regard both to which factors should be considered as well as the effect of them when counseling patients regarding likelihood of vision recovery. 5,[13][14][15] This is important information, especially for patients who may be at higher risk from surgical intervention. For benign lesions with a low chance of vision recovery, the risks of surgery may not be acceptable to many patients.…”

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confidence: 99%

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

Stippler¹,

Morley²,

Myers³

2011

Skull Base

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

2012

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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.

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Predicting visual recovery following optic nerve decompression for chronic optic neuropathy

Cited by 3 publications

References 5 publications

Endoscopic Endonasal Optic Nerve Decompression for Fibrous Dysplasia

Endoscopic Endonasal Optic Nerve Decompression for Fibrous Dysplasia

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

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

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