May 2003
Volume 44, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2003
PET Scan Changes Following Optic Nerve Sheath Fenestration for Pseudotumor Cerebri
Author Affiliations & Notes
  • S. Bose
    Ophthalmology, Univ of California-Irvine, Irvine, CA, United States
  • T. McCulley
    Ophthalmology, Univ of California-Irvine, Irvine, CA, United States
  • M. Taban
    Ophthalmology, Univ of California-Irvine, Irvine, CA, United States
  • J. Fallon
    Ophthalmology, Univ of California-Irvine, Irvine, CA, United States
  • S. Potkin
    Ophthalmology, Univ of California-Irvine, Irvine, CA, United States
  • Footnotes
    Commercial Relationships  S. Bose, None; T. McCulley, None; M. Taban, None; J. Fallon, None; S. Potkin, None.
  • Footnotes
    Support  GCRC
Investigative Ophthalmology & Visual Science May 2003, Vol.44, 2725. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      S. Bose, T. McCulley, M. Taban, J. Fallon, S. Potkin; PET Scan Changes Following Optic Nerve Sheath Fenestration for Pseudotumor Cerebri . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2725.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Abstract: : Background. The mechanism by which optic nerve sheath fenestration (ONSF) improves visual function is still under debate. To date, there has not been any comprehensive functional neuroimaging study that provides information regarding metabolic changes in the brain in patients with pseudotumor cerebri (PTC) before and after ONSF. Objectives: To describe changes in the glucose metabolic rate of the brain and anterior visual pathways following ONSF using positron emission tomography (PET) scanning. Methods: A 19-year-old obese white female diagnosed with PTC presented with a severe visual loss in her right eye to light perception, 20/25 OS, bilateral disc edema; normal Brain CT and MRI, and a CSF opening pressure of 350 mm H2O with normal cytology. A PET scan with fluoride-18 fluorodeoxyglucose (FDG) was performed. The patient underwent ONSF of the right eye via a medial approach and she underwent repeat FDG PET scanning on post-operative day 8; her VA improved to 20/25 OD. Results: Presurgery, the PET scan revealed dramatic bilateral metabolic changes compared with 56 controls. However, the primary (BA 17) and proximal (BA 18,19) visual cortices do not show any differences, except in BA 19 in the dorsal visual stream. Postsurgery, relative to the visual system, significant bilateral increases in uptake along the path of the optic nerves, optic radiations and in most of occipital, temporal, parietal visual processing system were observed. Although the differences noted presurgery in the non-primary visual areas of the brain remain, or even accentuated, the presurgery hypermetabolism in primary visual cortex appear to have been reversed by the surgery. Conclusion: Metabolic imaging with FDG-PET provides functional information not attainable with MRI, MRA, or MR spectroscopy since PTC patients, as in this case, can have abnormal PET studies despite normal conventional neuroimaging. ONSF or a reduction in ICP appears to reverse the GMR in the dorsal and ventral visual streams.

Keywords: neuro-ophthalmology: optic nerve • pathobiology • visual cortex 
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×