OPTIC-NERVE SHEATH DECOMPRESSION IN PEDIATRIC PSEUDOTUMOR CEREBRI

The authors report a retrospective review of two cases of optic nerve sheath decompression in children (age younger than 16 years) and revie w the literature on the procedure. Two children underwent optic nerve sheath decompression. Optic disc edema resolved in both eyes after sur gery. Some degree of visual improvement was obtained in one eye of eac h patient after surgery, but one eye was unchanged in one patient and one eye of the other patient had worsening of visual acuity after surg ery. Neither patient suffered any systemic complications from the proc edure. Of 12 patients in the literature (including these 2 patients), 66% experienced improved visual acuity following optic nerve sheath de compression, 33% had improvement in visual field, and 17% suffered wor sening of visual acuity and visual field after surgery. Although optic nerve sheath decompression is a relatively safe and effective treatme nt for visual loss due to papilledema in adults, significant complicat ions, including further visual loss, may occur. The experience with th is procedure in children is limited, but retrospective data suggest th at the safety and efficacy of the procedure may be comparable with tha t in adult patients.