This is a case report about a patient with chronic papilledema, who was diagnosed with idiopathic intracranial hypertension (IIH) and who developed optic nerve head atrophy in the left eye and progressive visual field defect in both eyes.
Material and methods
An IIH patient with a 4-year history of chronic papilledema did not show response to the standard pharmacological treatment of acetazolamide and Solu-Medrol, and underwent optic nerve sheath fenestration (ONSF) of the left eye with atrophic nerve.
After the surgery and a follow-up of 1 year, visual field defect progression in the left eye stopped. Visual acuity remained 20/20. Thus, although the chronic papilledema in the right eye was still present, vision acuity and visual field were stable.
ONSF should be considered as a treatment of choice for IIH in patients who do not respond to pharmacological treatment and who show progressive visual field defect.