Optic nerve sheath fenestration in cryptococcal meningitis

Case report

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Authors: Tatyana Milman, Neena Mirani, Roger E Turbin

Published Date October 2008 Volume 2008:2(3) Pages 637 - 639

DOI: http://dx.doi.org/10.2147/OPTH.S2096

Tatyana Milman¹, Neena Mirani^1,2, Roger E Turbin¹

¹Ophthalmology Department, Institute of Ophthalmology and Visual Science, ²Pathology Department, University Hospital, New Jersey Medical School, Newark, NJ, USA

Abstract: A patient with acquired immunodeficiency syndrome (AIDS) developed crytpococcal meningitis, complicated by papilledema and severe progressive visual loss despite medical therapy. Bilateral optic sheath fenestration resulted in significant improvement in vision and resolution of papilledema. Histopathologic evaluation of the optic nerve sheath demonstrated numerous cryptococci. Optic nerve sheath fenestration may be an effective treatment method when high intracranial pressure is contributing to visual loss, even in the presence of involvement of the optic nerve sheath by the fungus.

Keywords: optic nerve sheath, cryptococcal, meningitis, fenestration