Pediatric optic nerve sheath decompression.
PURPOSE: To review our experience with optic nerve sheath decompression for pediatric pseudotumor cerebri. DESIGN: Retrospective chart review. PARTICIPANTS: Seventeen eyes in 12 children younger than 16 years of age. All patients were either unresponsive or intolerant to medication. INTERVENTION, METHODS, OR TESTING: An optic nerve sheath fenestration was performed. MAIN OUTCOME MEASURES: Optic nerve appearance, visual acuity, color vision, and visual fields. RESULTS: The average age at surgery was 10.1 years of age. The average follow-up was 39.6 months. Headache was the most common presenting symptom. All patients showed improvement in optic nerve edema. Visual acuity improved or stayed the same in all surgical eyes (P = 0.0078). One patient required a neurosurgical lumbar peritoneal shunt, and 2 patients required acetazolamide on the last follow-up appointment. No patient had postoperative infection, loss of vision, or strabismus develop. Five of the patients in this study required sheath decompression on the other eye. CONCLUSIONS: Optic nerve sheath decompression in children is safe, and the results are similar to those obtained in adults. Close follow-up is required, because 5 of 12 patients in this study required a contralateral optic nerve sheath decompression.
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