Tags

Type your tag names separated by a space and hit enter

Optic nerve decompression improves hemodynamic parameters in papilledema.
Ophthalmology. 1993 Jul; 100(7):987-97.O

Abstract

PURPOSE

The purpose of this study is to examine changes in color Doppler imaging parameters before and after optic nerve sheath decompression (ONSD) for chronic papilledema caused by pseudotumor cerebri (PTC).

METHODS

Color Doppler imaging was performed within 48 hours before surgery and within 48 hours after the procedure using a color Doppler unit with a 7.5-MHz phased linear transducer. Pulsed Doppler spectrum analyses were recorded digitally on videotape from the ophthalmic, central retinal, and short posterior ciliary arteries, using a 0.4 x 0.6-mm sample volume.

RESULTS

Blood flow velocities in the ophthalmic, short posterior ciliary, and central retinal arteries of 24 eyes were significantly decreased compared with a healthy age-matched group. Eyes with visual acuities worse than 20/30 before surgery had significantly decreased velocities in the ophthalmic, short posterior ciliary, and retinal arteries, whereas in eyes with visual acuities better than 20/30, only the short posterior ciliary and central retinal arteries demonstrated decreased velocities. In addition, Gosling's pulsatility index was increased for the central retinal artery but not the ophthalmic or short posterior ciliary arteries. Thirteen eyes improving in visual acuity and field after ONSD demonstrated significant improvement in all color Doppler imaging parameters for the short posterior ciliary arteries. The ophthalmic artery diastolic velocity also increased significantly but the central retinal artery parameters did not change. The eyes that remained stable or worsened did not demonstrate significant postoperative changes.

CONCLUSION

These results suggest that some of the visual loss from chronic papilledema may be due to ischemia, and worsening visual acuity correlates with greater impairment of the retrobulbar circulation. One of the mechanisms by which ONSD improves visual function may be reversal of this ischemic process.

Authors+Show Affiliations

Neuro-Ophthalmology Service, Wills Eye Hospital, Philadelphia, PA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8321541

Citation

Mittra, R A., et al. "Optic Nerve Decompression Improves Hemodynamic Parameters in Papilledema." Ophthalmology, vol. 100, no. 7, 1993, pp. 987-97.
Mittra RA, Sergott RC, Flaharty PM, et al. Optic nerve decompression improves hemodynamic parameters in papilledema. Ophthalmology. 1993;100(7):987-97.
Mittra, R. A., Sergott, R. C., Flaharty, P. M., Lieb, W. E., Savino, P. J., Bosley, T. M., & Hedges, T. R. (1993). Optic nerve decompression improves hemodynamic parameters in papilledema. Ophthalmology, 100(7), 987-97.
Mittra RA, et al. Optic Nerve Decompression Improves Hemodynamic Parameters in Papilledema. Ophthalmology. 1993;100(7):987-97. PubMed PMID: 8321541.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optic nerve decompression improves hemodynamic parameters in papilledema. AU - Mittra,R A, AU - Sergott,R C, AU - Flaharty,P M, AU - Lieb,W E, AU - Savino,P J, AU - Bosley,T M, AU - Hedges,T R,Jr PY - 1993/7/1/pubmed PY - 2001/3/28/medline PY - 1993/7/1/entrez SP - 987 EP - 97 JF - Ophthalmology JO - Ophthalmology VL - 100 IS - 7 N2 - PURPOSE: The purpose of this study is to examine changes in color Doppler imaging parameters before and after optic nerve sheath decompression (ONSD) for chronic papilledema caused by pseudotumor cerebri (PTC). METHODS: Color Doppler imaging was performed within 48 hours before surgery and within 48 hours after the procedure using a color Doppler unit with a 7.5-MHz phased linear transducer. Pulsed Doppler spectrum analyses were recorded digitally on videotape from the ophthalmic, central retinal, and short posterior ciliary arteries, using a 0.4 x 0.6-mm sample volume. RESULTS: Blood flow velocities in the ophthalmic, short posterior ciliary, and central retinal arteries of 24 eyes were significantly decreased compared with a healthy age-matched group. Eyes with visual acuities worse than 20/30 before surgery had significantly decreased velocities in the ophthalmic, short posterior ciliary, and retinal arteries, whereas in eyes with visual acuities better than 20/30, only the short posterior ciliary and central retinal arteries demonstrated decreased velocities. In addition, Gosling's pulsatility index was increased for the central retinal artery but not the ophthalmic or short posterior ciliary arteries. Thirteen eyes improving in visual acuity and field after ONSD demonstrated significant improvement in all color Doppler imaging parameters for the short posterior ciliary arteries. The ophthalmic artery diastolic velocity also increased significantly but the central retinal artery parameters did not change. The eyes that remained stable or worsened did not demonstrate significant postoperative changes. CONCLUSION: These results suggest that some of the visual loss from chronic papilledema may be due to ischemia, and worsening visual acuity correlates with greater impairment of the retrobulbar circulation. One of the mechanisms by which ONSD improves visual function may be reversal of this ischemic process. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/8321541/Optic_nerve_decompression_improves_hemodynamic_parameters_in_papilledema_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(93)31526-5 DB - PRIME DP - Unbound Medicine ER -