Abstract

PURPOSE: Papilledema due to persistently high intracranial hypertension leads to visual loss due to development of atrophy. We are aware that optic nerve sheath fenestration (ONSF) has been shown to stabilize vision in papilledema but will it work in atrophic papilledema (AP)? We report our experience of ONSF on visual loss in AP
METHODS: Retrospective analysis of all patients who underwent ONSF for AP with minimum 6weeks follow up
RESULTS: Total 26 eyes of 13 patients were included with visual acuity from doubtful perception of light(PL) to 6/60. All had either no or resolving disc edema with atrophy and progressive visual loss. In view of the significant subarachnoid fluid around optic nerve head on B-scan, ONSF was performed after which vision either improved or stabilised in all except 4 with doubful PL. Except for neuropraxia in 1, no major complication was noted
CONCLUSION: ONSF can salvage vision even in AP inspite of profound visual loss unless vision loss is complete

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