Compressive optic neuropathy from anterior clinoid process pneumatization: multi-model imaging and outcomes

Abstract Objective Anterior clinoid process (ACP) pneumatization is an uncommon entity. The goal of the research was to explore the diagnostic characteristics and prognosis of the compressive optic neuropathy (CON) caused by ACP pneumatization. Methods Clinical information were retrospectively gathered via those in hospitals diagnosed alongside CON companied with ACP pneumatization at the Neuro-Ophthalmology Department at the Chinese People’s Liberation Army General Hospital from January 2021 to August 2023. Results A overall of thirteen sufferers ( three females and ten males, sixteen involved eyes) participated alongside an average age of 34.38 ± 16.12 years. All the eyes were assessed with the ACP pneumatization classification system established by Da Costa:pneumatization Type 0 occurred in 3/26 sides (11.5%), Type 1 in 8/26 sides (30.8%), Type 2a in 8/26 sides (30.8%), Type 2b in 5/26 sides (19.2%), Type 3 in 2/26 sides (7.7%). 69.6% (16/23) eyes had optic compressive neuropathy in these patients.Among the ten patients with bilateral pneumatization, only three induced bilateral compressive optic neuropathy. 37.5%(6/16) eyes with visual field defect as the first symptom. Ultimately, two patients had endoscopic sphenoidotomy and optic canal decompression surgery, resulting in improved visual acuity in the operated eyes. Conclusions CON caused by ACP pneumatization can lead to transient visual obscuration, varying degrees of visual field defects and vision loss. HRCT is advised in cases of unexplained vision loss and visual field defects to determine whether or not ACP gasification is occurring. While whether it requires surgery intervention and its effectiveness, still require large-scale research and verification.