PMID- 24759290
OWN - NLM
STAT- MEDLINE
DCOM- 20141021
LR  - 20180508
IS  - 1537-2677 (Electronic)
IS  - 0740-9303 (Linking)
VI  - 30
IP  - 3
DP  - 2014 May-Jun
TI  - Transcranial orbital decompression for progressive compressive optic neuropathy 
      after 3-wall decompression in severe graves' orbitopathy.
PG  - 215-8
LID - 10.1097/IOP.0000000000000052 [doi]
AB  - PURPOSE: To determine surgical outcomes after transcranial decompression of the 
      superior orbit in patients with progressive compressive optic neuropathy (CON) 
      secondary to Graves' orbitopathy (GO) who had previously been treated with 3-wall 
      decompression. METHODS: Approval from the West Virginia University Institution 
      Review Board was obtained. A retrospective review of 4 patients with GO who 
      received bilateral transcranial decompression of the orbits for progressive 
      compressive optic neuropathy after bilateral maximal extracranial 3-wall 
      decompression was performed. The patients were treated by the Multidisciplinary 
      Orbit and Skull Base Services at West Virginia University and the University of 
      Michigan. RESULTS: Bilateral transcranial decompression of the orbit for GO was 
      performed on 8 orbits in 4 patients. All 8 orbits had radiographic evidence of 
      compression of the orbital apex, and all patients had been treated with steroids, 
      orbital radiation, and bilateral 3-wall decompression. Preoperative vision ranged 
      from 20/25 to 20/100, which improved to 20/25 or better in all eyes. The visual 
      field mean deviation improved from a mean of -13.05 to -1.67 dB. Hertel 
      measurements improved from a mean of 19.25 to 15.25 mm. Extraocular motility was 
      essentially unchanged. Two patients were noted to have asymptomatic ocular 
      pulsations. There were no other complications, and all patients remained stable 
      during a follow-up period of 5 years (range 2-8 years). CONCLUSIONS: Transcranial 
      decompression is an effective and safe method of salvaging vision when standard 
      treatments fail. This is only the second report of transcranial decompression for 
      refractory compressive optic neuropathy after decompression from a standard 
      approach.
FAU - Bingham, Chad M
AU  - Bingham CM
AD  - *Department of Ophthalmology, West Virginia University Eye Institute; daggerDepartment 
      of Neurosurgery, West Virginia University, Morgantown, West Virginia; double daggerDepartment 
      of Otolaryngology, and  section signDepartment of Ophthalmology, Kellogg Eye Center, 
      University of Michigan, Ann Arbor, Michigan, U.S.A.
FAU - Harris, Matheson A
AU  - Harris MA
FAU - Vidor, Ira A
AU  - Vidor IA
FAU - Rosen, Charles L
AU  - Rosen CL
FAU - Linberg, John V
AU  - Linberg JV
FAU - Marentette, Lawrence J
AU  - Marentette LJ
FAU - Elner, Victor M
AU  - Elner VM
FAU - Sivak-Callcott, Jennifer A
AU  - Sivak-Callcott JA
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Ophthalmic Plast Reconstr Surg
JT  - Ophthalmic plastic and reconstructive surgery
JID - 8508431
SB  - IM
MH  - Aged
MH  - Decompression, Surgical/*methods
MH  - Female
MH  - Graves Ophthalmopathy/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nerve Compression Syndromes/etiology/*surgery
MH  - Optic Nerve Diseases/etiology/*surgery
MH  - Orbit/*surgery
MH  - Orbital Diseases/*surgery
MH  - *Postoperative Complications
MH  - Treatment Outcome
MH  - Visual Acuity/physiology
MH  - Visual Fields/physiology
EDAT- 2014/04/25 06:00
MHDA- 2014/10/22 06:00
CRDT- 2014/04/25 06:00
PHST- 2014/04/25 06:00 [entrez]
PHST- 2014/04/25 06:00 [pubmed]
PHST- 2014/10/22 06:00 [medline]
AID - 10.1097/IOP.0000000000000052 [doi]
PST - ppublish
SO  - Ophthalmic Plast Reconstr Surg. 2014 May-Jun;30(3):215-8. doi: 
      10.1097/IOP.0000000000000052.