We read with interest the report by Jablons et al1 in the January 1993 issue of the Archives of 26 patients who underwent optic nerve sheath fenestration for treatment of progressive ischemic optic neuropathy. Although we have had different results in our series of 23 eyes,2 our sample may be significantly different from the series from the Bascom Palmer Eye Institute, Miami, Fla. Only one (6%) of 17 patients tested had intranerve sheath fluid on 30° A-scan echography in the Bascom Palmer series.3 In our series, 12 of 12 subjects tested positive for intranerve sheath fluid and 11 (92%) of 12 experienced improvement of 2 or more lines after optic nerve sheath decompression (ONSD). If this is analyzed according to visual acuity, nine of 10 patients with visual acuity of 20/60 or worse experienced improvement of 2 or more lines.
These results are significantly better than those
McHenry JG, Spoor TC. Optic Nerve Sheath Fenestration for Treatment of Progressive Ischemic Optic Neuropathy. Arch Ophthalmol. 1993;111(12):1601. doi:10.1001/archopht.1993.01090120015001