Quantitative Ultrasonography in Orbital Optic Nerve Decompression

  • Harold W. Skalka

Abstract

Decompression of the orbital optic nerve by incision, or preferably, excision of a portion of the retrobulbar nerve sheaths is an accepted procedure in the management of patients who are developing visual defects due to otherwise uncontrollable chronic papilledema 1–7. Usually, but not always, the papilledema is due to increased intracranial pressure8. A major category of such patients are those with pseudotumor cerebri with chronic papilledema and visual field compromise who are not responding adequately to medical therapy. Previously, a widened cerebrospinal fluid cuff around the retrobulbar optic nerve was assumed on the basis of papilledema and (usually) increased intracranial pressure. Pseudotumor cerebri (or other) patients with optic atrophy unable to develop papilledema, and papilledema patients without elevated cerebrospinal fluid pressure on lumbar puncture, could not be adequately evaluated, and the potential benefits of orbital optic nerve decompression were often withheld due to inability to predict the presence of decompressible fluid about the retrobulbar optic nerves.

Keywords

Lution Reso Papilledema Cerebro 

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References

  1. 1.
    Hayreh, S. S., Pathogenesis of Oedema of the Optic Disc (Papilloedema); a Preliminary Report, Brit J Ophthal 48:522, 1964.Google Scholar
  2. 2.
    Hayreh, S. S., Pathogenesis of Oedema of the Optic Disc, Doc Ophthal, 24:289–411, 1968.CrossRefGoogle Scholar
  3. 3.
    Davidson, S. I., A Surgical Approach to Plerocephalic Disc Oedema, Trans Ophthal Soc UK, 89:669–690, 1969.Google Scholar
  4. 4.
    Galbraith, J. E. K., and Sullivan, J. H., Decompression of the Perioptic Meninges for Relief of Papilledema, Amer J Ophthal, 76:687–692, 1973.PubMedGoogle Scholar
  5. 5.
    Burde, R. M., Karp, J. S., and Miller, R. N., Reversal of Visual Deficit with Optic Nerve Decompression in Long-Standing Pseudotumor Cerebri, Amer J Ophthal, 77:770–772, 1974.PubMedGoogle Scholar
  6. 6.
    Billson, F. A., and Hudson, R. L., Surgical Treatment of Chronic Papilloedema in Children, Brit J Ophthal, 59:92–95, 1975.PubMedCrossRefGoogle Scholar
  7. 7.
    Keltner, J. L., Albert, D. M., Lubow, M., Fritsch, E., and Davey, L. M., Optic Nerve Decompression, Arch Ophthal, 95:97–104, 1977.PubMedCrossRefGoogle Scholar
  8. 8.
    Smith, J. L., Hoyt, W. F., and Newton, T. H., Optic Nerve Sheath Decompression for Relief of Chronic Monocular Choked Disc, Amer J Ophthal, 68:633–639, 1969.PubMedGoogle Scholar
  9. 9.
    Skalka, H. W., Ultrasound in Clinical Medicine, Vol. 3A, Clinical Aspects, Plenum Pub. Co., New York, 1977.Google Scholar
  10. 10.
    Galbraith, J. E. K., Optic Nerve Decompression in Benign Intracranial Hypertension, Trans of the Ophthal Soc of New Zealand, Vol. 25:165–170, 1973.Google Scholar
  11. 11.
    Walsh, F. D., and Hoyt, W. F., Clinical Neuroophthalmology, P. 575, Williams and Wilkins, Baltimore, 1969.Google Scholar

Copyright information

© American Institute of Ultrasound in Medicine and Plenum Press, New York 1978

Authors and Affiliations

  • Harold W. Skalka
    • 1
  1. 1.Combined Program in Ophthalmology Eye Foundation HospitalUniversity of Alabama in BirminghamBirminghamUSA

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