November 25, 2002
1 min read
Save

Optic nerve decompression not always indicated for fibrous dysplasia, surgeons say

SAN FRANCISCO — The presence of fibrous dysplasia alone, without associated visual loss, is not sufficient to warrant prophylactic decompression of the optic nerve, surgeons here advise.

Janice S. Lee, DDS, MD, and colleagues here and elsewhere studied 38 patients with fibrous dysplasia of the lesser wing of the sphenoid bone. They compared the results of computed tomography and ophthalmologic examination in these patients to results in 38 age- and sex-matched controls.

Twelve of the 38 patients had polyostotic fibrous dysplasia, and 26 had McCune-Albright syndrome. Of the 67 optic canals that were affected by fibrous dysplasia, 49 were completely encased.

In all but two of the patients, the neuro-ophthalmologic exams were normal. In the two patients with monocular visual impairment, the areas of the optic canals were similar on the normal and abnormal sides.

Because encasement of the optic canal in fibrous dysplasia causes narrowing of the canal but does not necessarily result in visual loss, the authors suggest that prophylactic decompression based on diagnostic imaging alone does not appear to be indicated.

The study is published in the November issue of The New England Journal of Medicine.