PMC10359689_01
Standard automated visual field (SAP), fundus photography, and OCT macular scans at the initial visit, at 2 weeks, 8 weeks, and 6 months posttreatment. Optic nerve swelling decreased significantly across visits. In the right eye, the macular edema resolved 2 weeks after the optic nerve sheath fenestration. Six months later, there was no papillary or macular edema. Automated visual field progression demonstrating significant central visual loss in the OD and enlarged blind spot in the OS. OS, left eye.
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F1
Fundus examination showed swollen optic discs in both eyes (Fig. 1). OD and enlargement of blind spot in the left eye (Fig. 1). Optical coherence tomography showed marked increased peripapillary retinal layer thickness around the disc (Fig. 1).
Line OCT scans in the optic nerve head. Right eye (a and c) left eye (b and d). Note the anterior displacement of the optic nerve head in the right eye indicating the posterior polar flattening caused by the intracranial hypertension (a), and the improvement 2 weeks after the optic nerve sheath fenestration (d).
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F2
A longitudinal line-scan passing through the optic nerve showed bulging of the posterior scleral indicating elevated pressure at the optic nerve sheath (Fig. 2). ATRA, acetazolamide therapy, and ONSF surgery, papilledema and abducens paresis resolved (Fig. 2). After a 6-month period, the best corrected visual acuity was 20/20 and visual fields were normal in both eyes.