Evaluation of papilledema and visual improvement in patients with idiopathic intracranial hypertension after venous sinus stenting
10.3760/cma.j.cn112139-20210505-00193
- VernacularTitle:特发性颅内高压患者行静脉窦支架成形术后视乳头水肿及视力改善情况分析
- Author:
Wei WANG
1
;
Qiang JIA
;
Yimu FAN
;
Xudong LI
;
Shibo WANG
;
Lei CHENG
;
Hongguang WANG
;
Weilun LIANG
;
Lingzhai BIAN
;
Xiaoguang TONG
Author Information
1. 天津医科大学研究生院 300070
- Keywords:
Intracranial hypertension;
Stents;
Venous sinus stenosis;
Optical coherence tomography;
Retinal nerve fiber layer
- From:
Chinese Journal of Surgery
2021;59(12):1012-1017
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the improvement of papilledema and visual acuities in patients with idiopathic intracranial hypertension (IIH) after venous sinus stenting.Methods:The clinical data of 8 IIH patients who met the inclusion criteria underwent venous sinus stenting between January 2013 and December 2016 at Department of Neurosurgery, Tianjin Huanhu Hospital were analyzed retrospectively. There were 6 females and 3 males,aged (32.9±14.4)years (range:19 to 57 years).The thickness of the retinal nerve fiber layer (RNFL) was measured by optical coherence tomography. Fundus,visual acuity and visual field examination were performed before and after operation. If pressure gradient ≥10 mmHg(1 mmHg=0.133 kPa) across the venous stenosis was indicated by intraoperative pressure measurement,the patient would be treated with venous sinus stenting. Intracranial pressure was measured by lumbar puncture 3 to 7 days after operation. RNFL thickness and eye examination were detected 6 months after surgery. CT venogram was used to observe the sinus venous conditions. Paired t test was used to compare the data before and after surgery. Results:All the 8 patients underwent venous sinus stenting successfully. The mean pressure gradient across the venous stenosis was reduced from (24±9.2) mmHg to (2.6±2.0) mmHg ( t=8.02, P<0.01). Intracranial pressure decreased from preoperative (41.4±12.7) cmH 2O(1 cmH 2O=0.098 kPa) to postoperative (12.9±3.3) cmH 2O ( t=7.08, P<0.01). The RNFL thickness decreased from (275.3±68.3)μm to (131.4±31.8)μm( t=5.80, P<0.05) 6 months after surgery and the baseline visual acuity was improved from( M( Q R))0.24 (0.25) to 0.65 (0.23)( Z=-2.52, P<0.05).Papilledema was significantly improved in 6 patients,and no significant change in 2 patients. CT venogram indicated adjacent stent restenosis in 1 patient. Conclusion:Venous sinus stenting can effectively improve papilledema and visual acuity caused by IIH.
