Update on the application of optic nerve sheath fenestration

Article type: Research Article

Authors: Chen, Hui^{a; b; *; 1} | Zhang, Qian^{a; 1} | Tan, Song^c | Fu, Huazhu^g | Farris, Bradley K.^{e; f; *} | Yang, Zhenglin^{d; *}

Affiliations: [a] Department of Ophthalmology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu City, Sichuan Province, China | [b] Laboratory Animal Institute, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu City, Sichuan Province, China | [c] Department of Neurology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu City, Sichuan Province, China | [d] Sichuan Provincial Key Laboratory for Disease Gene Study, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu City, Sichuan Province, China | [e] Department of Ophthalmology, University of Oklahoma School of Medicine, Oklahoma City, OK, USA | [f] Department of Ophthalmology, Dean A. McGee Eye Institute, University of Oklahoma School of Medicine, Oklahoma City, OK, USA | [g] Institute for Infocomm Research, Agency for Science, Technology and Research (A*STAR), Singapore

Correspondence: [*] Corresponding author. Hui Chen, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, No. 32, 1st ring road, 2nd west section, Chengdu City, Sichuan Province 610072, China. Tel.: +86 18981838590; Fax: +86 028 8779 5585; E-mail: 540685790@qq.com.; Zhenglin Yang, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, No. 32, 1st ring road, 2nd west section, Chengdu City, Sichuan Province 610072, China. Tel.: +86 18981838963; Fax: +86 028 8779 5585; E-mail: zliny@yahoo.com. and Bradley K. Farris, Department of Ophthalmology, Dean A. McGee Eye Institute, University of Oklahoma Health Sciences Center, 608 Stanton L. Young Boulevard, Oklahoma City, OK 73104, USA. Tel.: +1 405 271 1091; Fax: +1 405 271 1226; E-mail: bradley-farris@dmei.org.

Note: [1] Hui Chen and Qian Zhang are co-first authors.

Abstract: Background:With the ongoing development of surgical procedures and instruments, the safety of optic nerve sheath fenestration (ONSF) has been improved. Objective:Through the past three decades, progress has been made in preventing visual loss from chronic optic nerve swelling in idiopathic intracranial hypertension (IIH), secondary intracranial hypertension and local optic nerve diseases. We now review the updated application of ONSF in those diseases. Methods:The application of ONSF in papilledema due to IIH, secondary intracranial hypertension to cerebral venous sinus occlusion, Cryptococcal meningitis, and intracranial mass or tumors is reviewed. Additionally, the potential benefits of ONSF in local optic neuropathy from optic nerve sheath meningioma, optic nerve drusen, traumatic optic neuropathy and optic nerve/sheath biopsy are also described. Results:Although ONSF has little or no effect on intracranial pressure, it is a safe, relative easy and effective surgical procedure to prevent or reverse visual loss in IIH. When other treatment modalities fail to timely protect vision, ONSF can be useful in protecting visual function or delay visual loss in secondary intracranial hypertension. Conclusion:We recommend that ONSF should be considered as a meaningful alternative or an adjunct therapy to reduce or delay the visual morbidity of these diseases, although the use of ONSF for some of them remains controversial.

Keywords: Optic nerve sheath fenestration (ONSF), idiopathic intracranial hypertension (IIH), secondary intracranial hypertension, optic neuropathy

DOI: 10.3233/RNN-160693

Journal: Restorative Neurology and Neuroscience, vol. 35, no. 3, pp. 275-286, 2017