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December 1993

Optic Nerve Sheath Fenestration for Treatment of Progressive Ischemic Optic Neuropathy-Reply

Author Affiliations

Miami, Fla

Arch Ophthalmol. 1993;111(12):1601-1602. doi:10.1001/archopht.1993.01090120015002

In reply  McHenry and Spoor raise an interesting point that fluid accumulation in theperioptic meninges may be associated with a progressive course of visual loss and better surgical outcome following ONSD in patients with AION. In our series of 26 eyes with progressive AION,1 only one of 17 eyes showed meager increased fluid in the subarachnoid space. In fact, in the Echography Laboratory of the Bascom Palmer Eye Institute, Miami, Fla, using standardized A-scan echography, we do not find increased sheath fluid in cases of AION, whether progressive or static.The surgical series of Spoor et al2 was recently published, including sonographic data on 12 eyes with progressive AION and 27 eyes with static AION. Mean optic nerve diameter in the progressive group was 3.47 mm, with afluid shift (30° test) rangingfrom 5% to 25%, and mean optic nerve diameter in the static group was 3.19 mm, with afluid shift

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