Cerebrospinal fluid and optic nerve sheath compartment syndrome: A common pathophysiological mechanism in five different cases?

Jie Hao, Achmed Pircher, Neil R. Miller, Jiemei Hsieh, Luca Remonda, Hanspeter E. Killer

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Importance: Optic nerve (ON) dysfunction is a common feature of different diseases. The pathophysiology is not yet fully understood. Background: This study describes five patients with ON sheath (ONS) compartment syndrome (ONSCS) and contributes to the hypothesis that impaired cerebrospinal fluid (CSF) flow can play a role in the development of ON dysfunction. Design: Retrospective case series. Participants: Five patients with ONSCS were included in the study. Methods: Elaboration of medical histories and clinical and diagnostic findings over a long time period was carried out by analysing medical records and by a detailed medical consultation. Main Outcome Measures: The main outcome measures include clinical history; visual acuity; field, intraocular and CSF pressures; and contrast-loaded computed tomographic (CT) cisternography. Results: Compartmentation of the ONS demonstrated by contrast-loaded CT cisternography was the consistent finding in all five patients who demonstrated findings of ON dysfunction. The aetiologies varied and included meningitis, papilloedema, sphenoid wing meningioma, disc herniation and normal-tension glaucoma. Conclusion and Relevance: Compartmentation of the ONS with consecutively impaired CSF dynamics within the ON subarachnoid space can lead to ON dysfunction. Different aetiologies can cause the development of ONSCS.

Original languageEnglish (US)
Pages (from-to)212-219
Number of pages8
JournalClinical and Experimental Ophthalmology
Volume48
Issue number2
DOIs
StatePublished - Mar 1 2020

Keywords

  • cerebrospinal fluid
  • cisternography
  • normal-tension glaucoma and papilloedema
  • optic nerve sheath compartment syndrome

ASJC Scopus subject areas

  • Ophthalmology

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