Acheson J F
Department of Neuro-Ophthalmology, National Hospital for Neurology and Neurosurgery, London, UK.
Eye (Lond). 2004 Nov;18(11):1169-74. doi: 10.1038/sj.eye.6701559.
Optic nerve sheath decompression (ONSD) maintains a role in the management of visual loss complicating papilloedema in selected patients primarily with idiopathic intracranial hypertension. The evidence base for this intervention is reviewed and audit data on visual outcomes for patients with acute, chronic, and atrophic forms of papilloedema are contrasted. Optic canal decompression has a role in the management of compressive optic neuropathies complicating mass lesions arising from paranasal sinuses and intracranially and can be achieved by transethmoidal, transbasal, and open craniotomy routes. The evidence base supporting this intervention in traumatic optic neuropathy and in primary bone disease causing canal stenosis (in particular fibrous dysplasia) is reviewed where the indications are more controversial.
视神经鞘减压术（ONSD）在某些主要患有特发性颅内高压的患者中，对于治疗伴有视乳头水肿的视力丧失仍具有一定作用。本文回顾了该干预措施的证据基础，并对比了急性、慢性和萎缩性视乳头水肿患者视力预后的审计数据。视神经管减压术在治疗因鼻窦和颅内肿块病变引起的压迫性视神经病变中具有一定作用，可通过经筛窦、经鼻基底和开颅手术途径实现。本文还回顾了支持该干预措施用于治疗创伤性视神经病变和导致管腔狭窄的原发性骨病（特别是骨纤维发育不良）的证据基础，而这些疾病的治疗指征更具争议性。
