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Lateral, medial orbital decompression successfully treats compressive optic neuropathy
Ophthal Plast Reconstr Surg. 2011;27(1):4-11.
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Lateral orbital decompression and medial orbital decompression showed positive visual outcomes at 3 months in patients with compressive optic neuropathy caused by thyroid eye disease, according to a study.
The retrospective chart review included 28 eyes of 17 patients who underwent either lateral wall decompression with deep bone removal (10 eyes) or transcaruncular medial decompression (18 eyes).
In order to determine the disease severity of each patient, researchers calculated a composite compressive optic neuropathy score, which included best corrected visual acuity, Humphrey visual field testing and color testing with Ishihara plates.
At 3-months follow-up, both groups showed significant improvements in all categories.
The composite compressive optic neuropathy score improved by 9.04 ± 9.97 points (P = .02) after lateral decompression and by 9.03 ± 10.84 points after medial decompression (P = .003), the study found.
Lateral decompression reduced proptosis by 6.3 mm, while medial decompression showed a reduction of 3.1 mm (P < .0001).
While there are some disadvantages to lateral decompression, the authors concluded that it should be considered a treatment option for thyroid eye disease-associated compressive optic neuropathy, especially with significant proptosis.