Spoor T C, Ramocki J M, Madion M P, Wilkinson M J
Department of Ophthalmology, School of Medicine, Wayne State University, Detroit, Michigan 48201.
Am J Ophthalmol. 1991 Aug 15;112(2):177-85. doi: 10.1016/s0002-9394(14)76698-x.
We performed optic nerve sheath decompression in 53 patients (101 eyes) with pseudotumor cerebri and visual loss. Sixty-nine eyes (85 patients) with acute papilledema uniformly had improved visual function after optic nerve sheath decompression. Of 32 eyes with chronic papilledema (18 patients), only ten had improved visual function after optic nerve sheath decompression. This difference was significant (P = .0001). Thirteen eyes required secondary or tertiary optic nerve sheath decompression after an initial successful result. Eleven of 13 eyes had improved visual function after repeat optic nerve sheath decompression. We believe that patients with acute papilledema and visual loss should be offered optic nerve sheath decompression, and if symptoms recur, repeat optic nerve sheath decompression is a safe and effective treatment option.
我们对53例（101只眼）伴有视力丧失的假瘤性脑脊髓炎患者实施了视神经鞘减压术。69只眼（85例患者）患有急性视乳头水肿，在视神经鞘减压术后视力功能均得到改善。在32只患有慢性视乳头水肿的眼睛（18例患者）中，只有10只在视神经鞘减压术后视力功能得到改善。这种差异具有显著性（P = .0001）。13只眼在初次手术成功后需要二次或三次视神经鞘减压术。13只眼中的11只在重复视神经鞘减压术后视力功能得到改善。我们认为，患有急性视乳头水肿和视力丧失的患者应接受视神经鞘减压术，并且如果症状复发，重复视神经鞘减压术是一种安全有效的治疗选择。
