Efficacy of Optic Nerve Sheath Fenestration in Patients with Increased Intracranial Pressure

Turk J Ophthalmol. 2023 Feb 24;53(1):13-17. doi: 10.4274/tjo.galenos.2022.45057.


Objectives: To evaluate the effectiveness of optic nerve sheath fenestration (ONSF) on visual functions in patients with increased intracranial pressure (İİP).

Materials and methods: The medical records of 24 eyes of 17 patients who had İİP due to idiopathic intracranial hypertension, cerebral venous sinus thrombosis, or intracranial cyst and underwent ONSF surgery to prevent visual loss were evaluated. Pre- and postoperative visual acuity, optic disc images, and visual field findings were reviewed.

Results: The mean age of the patients was 30.4±8.5 years, and 88.2% were female. The patients' mean body mass index was 28.67±6.1 kg/m2. The mean follow-up time was 24±12.1 months (range: 3-44). At postoperative 3 months, the mean best-corrected distance visual acuity had improved in 20 eyes (83.3%) and stabilized in 4 eyes (16.7%) compared to preoperative values. In visual field mean deviation, an improvement was observed in 10 eyes (90.9%), while 1 eye (9.1%) eye remained stable. Optic disc edema decreased in all patients.

Conclusion: This study indicates that ONSF has beneficial effects on visual function in patients with rapidly progressive visual loss caused by increased intracranial pressure.

Keywords: Idiopathic intracranial hypertension; optic nerve sheath fenestration; pseudotumor cerebri; visual field.

MeSH terms

  • Adult
  • Cysts*
  • Female
  • Humans
  • Intracranial Pressure
  • Male
  • Optic Disk*
  • Postoperative Period
  • Visual Acuity
  • Young Adult