Quantitative Ultrasonography in Orbital Optic Nerve Decompression
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.
KeywordsOptic Nerve Optic Disc Optic Atrophy Optic Nerve Sheath Cerebrospinal Fluid Pressure
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- 1.Hayreh, S. S., Pathogenesis of Oedema of the Optic Disc (Papilloedema); a Preliminary Report, Brit J Ophthal 48:522, 1964.Google Scholar
- 3.Davidson, S. I., A Surgical Approach to Plerocephalic Disc Oedema, Trans Ophthal Soc UK, 89:669–690, 1969.Google Scholar
- 9.Skalka, H. W., Ultrasound in Clinical Medicine, Vol. 3A, Clinical Aspects, Plenum Pub. Co., New York, 1977.Google Scholar
- 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.Walsh, F. D., and Hoyt, W. F., Clinical Neuroophthalmology, P. 575, Williams and Wilkins, Baltimore, 1969.Google Scholar