Clinical experiences in the management of traumatic optic neuropathy

Chou, Ping-I; Sadun, Alfredo A.; Chen, Y. C.; Su, Wan‐Fu; Lin, Shinn‐Zong; Lee, C. C.

doi:10.3109/01658109609044636

Cited by 65 publications

(50 citation statements)

References 59 publications

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“…48,49 These figures are very much comparable with those achieved in patients treated with steroids, surgery, or a combination of both. 50 However, these results may be biased as patients with good initial VA would more likely be treated conservatively.…”

Section: Conservativesupporting

confidence: 82%

Traumatic Optic Neuropathy: A Review

Kumaran

Sundar

Chye

2015

Craniomaxillofacial Trauma & Reconstruction

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The aim of this article is to evaluate current literature on investigation and management of traumatic optic neuropathy (TON), propose recommendations for diagnosis and management, and explore novel future treatments. TON, though uncommon, causes substantial visual loss. Without clear guidelines, there is much ambiguity regarding its diagnosis and management. Investigation and treatment (conservative, medical, surgical, and combined) vary widely between centers. Electronic databases PubMed, MEDLINE, PROSPERO, CENTRAL, and EMBASE were searched for content that matched "Traumatic optic neuropathy." Articles with abstracts and full text available, published in the past 10 years, written English and limited to human adults, were selected. All study designs were acceptable except case reports and case series with fewer 10 patients. All abstracts were then evaluated for relevance. References of these studies were evaluated and if also relevant, included. A total of 2,686 articles were retrieved and 43 examined for relevance. Of these, 23 articles were included. TON is a clinical diagnosis. Visual-evoked potential is useful in diagnosis and prognosis. Computed tomography demonstrates canal fractures and concomitant injuries. Magnetic resonance images should be reserved for select and stable patients. Conservative treatment is appropriate in mild TON. Steroids are of questionable benefit and may be harmful. Surgery should be reserved for patients with radiological evidence of compression and individualized.

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Section: Conservativesupporting

confidence: 82%

Traumatic Optic Neuropathy: A Review

Kumaran

Sundar

Chye

2015

Craniomaxillofacial Trauma & Reconstruction

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“…It has been shown that baseline visual acuity of no light perception [34][35][36] or orbital fracture [34] would be poor prognostic factors for visual recovery. There was a visual acuity of no light perception in three cases of the EPO group who all had improvement after EPO treatment (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Erythropoietin: a novel treatment for traumatic optic neuropathy—a pilot study

Kashkouli

Pakdel

Sanjari

et al. 2010

Graefes Arch Clin Exp Ophthalmol

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“…8 9 Surgery to decompress the optic canal, via intracranial, transethmoidal, endonasal, even sublabial approaches has been advocated in many retrospective reports. [10][11][12][13] The reports of outcome after surgery are subject to several limitations: there is a tendency to operate on patients with no light perception, some case series include patients with direct optic nerve injury, many patients are also treated with steroids in high dosage, and there is an inherent difficulty defining improvement when the first assessment is made at the bedside and the final assessment in the clinic. Retrospective reports of the use of high-dose steroids are also subject to similar criticisms.…”

Section: Treatment Of Indirect Optic Nerve Injurymentioning

confidence: 99%