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Optic nerve sheath decompression may improve blood flow in anterior ischemic optic neuropathy.
Ophthalmology. 1993 Mar; 100(3):297-302; discussion 303-5.O

Abstract

PURPOSE

The purposes of this study are to evaluate the retrobulbar circulation in progressive nonarteritic ischemic optic neuropathy (NAION) and to assess changes in blood flow after optic nerve sheath decompression (ONSD).

METHODS

Twenty-five patients with progressive NAION were studied using color Doppler imaging (CDI) before and after ONSD. Blood flow velocities and vascular resistance were calculated for the ophthalmic artery, central retinal artery, and posterior ciliary arteries in each eye. Contralateral eyes served as the control group.

RESULTS

Preoperatively, the study group demonstrated significantly lower blood flow velocities in the central retinal artery (P < 0.002) and posterior ciliary arteries (P < 0.02) when compared with the contralateral control group. Postoperatively, there was a significant increase in blood flow velocity in the ophthalmic artery (P < 0.04) and the central retinal artery (P < 0.05) as well as a significant decrease in vascular resistance in the posterior ciliary arteries (P < 0.02) in the study group. There were no significant changes in blood flow velocity or vascular resistance in the contralateral control group. Long-term follow-up on eight patients suggests a persistence of this trend. Seventeen of the 25 operated eyes demonstrated a postoperative improvement in visual function, defined as a gain of two lines or more in Snellen visual acuity or at least 20 degrees of visual field expansion.

CONCLUSIONS

These data demonstrate that eyes with acute NAION have impaired blood flow when compared with the contralateral control group. Furthermore, they suggest that ONSD may improve blood flow to the ischemic optic nerve halting the progression of visual loss and in some cases improving visual function.

Authors+Show Affiliations

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

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8459996

Citation

Flaharty, P M., et al. "Optic Nerve Sheath Decompression May Improve Blood Flow in Anterior Ischemic Optic Neuropathy." Ophthalmology, vol. 100, no. 3, 1993, pp. 297-302; discussion 303-5.
Flaharty PM, Sergott RC, Lieb W, et al. Optic nerve sheath decompression may improve blood flow in anterior ischemic optic neuropathy. Ophthalmology. 1993;100(3):297-302; discussion 303-5.
Flaharty, P. M., Sergott, R. C., Lieb, W., Bosley, T. M., & Savino, P. J. (1993). Optic nerve sheath decompression may improve blood flow in anterior ischemic optic neuropathy. Ophthalmology, 100(3), 297-302; discussion 303-5.
Flaharty PM, et al. Optic Nerve Sheath Decompression May Improve Blood Flow in Anterior Ischemic Optic Neuropathy. Ophthalmology. 1993;100(3):297-302; discussion 303-5. PubMed PMID: 8459996.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optic nerve sheath decompression may improve blood flow in anterior ischemic optic neuropathy. AU - Flaharty,P M, AU - Sergott,R C, AU - Lieb,W, AU - Bosley,T M, AU - Savino,P J, PY - 1993/3/1/pubmed PY - 1993/3/1/medline PY - 1993/3/1/entrez SP - 297-302; discussion 303-5 JF - Ophthalmology JO - Ophthalmology VL - 100 IS - 3 N2 - PURPOSE: The purposes of this study are to evaluate the retrobulbar circulation in progressive nonarteritic ischemic optic neuropathy (NAION) and to assess changes in blood flow after optic nerve sheath decompression (ONSD). METHODS: Twenty-five patients with progressive NAION were studied using color Doppler imaging (CDI) before and after ONSD. Blood flow velocities and vascular resistance were calculated for the ophthalmic artery, central retinal artery, and posterior ciliary arteries in each eye. Contralateral eyes served as the control group. RESULTS: Preoperatively, the study group demonstrated significantly lower blood flow velocities in the central retinal artery (P < 0.002) and posterior ciliary arteries (P < 0.02) when compared with the contralateral control group. Postoperatively, there was a significant increase in blood flow velocity in the ophthalmic artery (P < 0.04) and the central retinal artery (P < 0.05) as well as a significant decrease in vascular resistance in the posterior ciliary arteries (P < 0.02) in the study group. There were no significant changes in blood flow velocity or vascular resistance in the contralateral control group. Long-term follow-up on eight patients suggests a persistence of this trend. Seventeen of the 25 operated eyes demonstrated a postoperative improvement in visual function, defined as a gain of two lines or more in Snellen visual acuity or at least 20 degrees of visual field expansion. CONCLUSIONS: These data demonstrate that eyes with acute NAION have impaired blood flow when compared with the contralateral control group. Furthermore, they suggest that ONSD may improve blood flow to the ischemic optic nerve halting the progression of visual loss and in some cases improving visual function. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/8459996/Optic_nerve_sheath_decompression_may_improve_blood_flow_in_anterior_ischemic_optic_neuropathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(93)31651-9 DB - PRIME DP - Unbound Medicine ER -