Three cases of endoscopic endonasal optic nerve decompression for nontraumatic optic neuropathy

The rate of traumatic or nontraumatic optic neuropathy has increased in recent decades. High dose steroid, surgery and combined treatment are used for management of optic neuropathy. Surgical intervention using an endoscopic intranasal approach is expected to provide a safe and effective method for optic nerve decompression. We present outcomes of three patients with neuropathy who underwent endoscopic optic nerve decompression. Of the three patients, two showed improvement: from hand motion to 0.8 and 0.63, respectively. However, one patient who was not able to perceive light did not improve vision after surgery. The difference between the recovered patients and the patient who did not show improvement may be a result of initial visual acuity. Early diagnosis and prompt surgical management could increase the likelihood of improved visual performance; however, this may be limited to patients whose initial visual acuity is better than light perception.