Traumatic Optic Neuropathy

Miller, Neil R.

doi:10.1055/s-0040-1722632

Cited by 15 publications

(32 citation statements)

References 64 publications

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“…All patients in the study were males; no females were included in our study. This is in accordance with various other studies on TON which showed a prevalence in males [16][17][18] and suggests that males are more prone to trauma compared with females. The median age of the patients in this study was 18 years.…”

Section: Discussionsupporting

confidence: 93%

Traumatic Optic Neuropathy: Analysis of Demographic and Clinical Parameters Over Three Years in a Tertiary Care Hospital in India

V¹,

Satyasri²,

Ahuja³

et al. 2022

Cureus

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BackgroundTreatment options for traumatic optic neuropathy (TON) are limited and the role of steroids in the treatment of TON is still controversial. Hence this study was planned to highlight the role of steroids in the treatment of TON. PurposeThe study aims to highlight the epidemiological and clinical characteristics, as well as the role of steroids, in TON cases seen during a three-year period at a tertiary care center in India. MethodsThis was a retrospective study that reviewed records of all cases of TON between January 2018 to January 2020. ResultsTwenty-three cases of TON were seen representing 1.26% cases of head injuries. The median age was 18 years. One patient (4.34%) had bilateral TON and 18 patients (78.26%) were referred from accident and trauma care. None of the patients presented directly to an ophthalmologist. The most common cause of injury was automobile accident (69.56%). Visual acuity at presentation was 20/80-20/100 in six (26.08%) cases. Fifteen (65.4%) patients had associated closed globe injury. Seven (30.43%) patients had ocular adnexal involvement and 10 (43.47%) patients had orbital fractures. Seventeen (73.91%) received steroid treatment and six of these patients showed visual improvement. ConclusionsThe study showed that there was no significant association between presenting visual acuity and treatment. The presence of significant ocular injury and orbital injury increased the likelihood of treatment. There was no difference between the treated and untreated groups with respect to final visual acuity.

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Section: Discussionsupporting

confidence: 93%

Traumatic Optic Neuropathy: Analysis of Demographic and Clinical Parameters Over Three Years in a Tertiary Care Hospital in India

V¹,

Satyasri²,

Ahuja³

et al. 2022

Cureus

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show abstract

“…Traumatic optic neuropathy (TON), the most common reason for visual loss after blunt head trauma, has an incidence of about 2.5-10% following blunt head trauma (1)(2)(3). According to the injury mechanism of the optic nerve, can TON be classified as either direct or indirect TON.…”

Section: Introductionmentioning

confidence: 99%

The outcome of surgical and non-surgical treatments for traumatic optic neuropathy: a comparative study of 685 cases

Wang¹,

Zhao²,

Li³

et al. 2022

Ann Transl Med

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Background: The choice and efficacy of surgical or/and surgical treatments for traumatic optic neuropathy (TON) remained controversial by now. This study aims to present the outcomes of surgical and nonsurgical treatments for TON in our center.Methods: A total of 685 consecutive patients were retrospectively included in the study. And divided into surgical and non-surgical groups. All cases were treated with corticosteroids for 3 days after admission.Endoscopic optic decompression was applied to 479 patients of surgical group; The other 206 patients of nonsurgical were administered with corticosteroids alone. The visual outcomes before and after treatment were compared with Wilcoxon rank and tests. The improvement rate between two groups were compared with chi-square test.Results: The visual acuity (VA) after treatment was significantly better than that before treatment (P=0.000).Overall VA improvement rate in the surgical group was better than that in non-surgical group (42.8% vs. 35.4%) with no significant difference (P=0.072). The VA improvement rate was significant greater in the surgical group than that in the non-surgical group in the patients with NLP before treatment (P=0.028). The VA improvement rate was better in the surgical group than that in the non-surgical group (71.9% vs. 57.8%) but with no significant difference. The final overall VA was 0.1 or better in 43 cases; 104 cases were able to count fingers; hand motion (HM) became perceivable in 132 cases; light perception (LP) was achieved in 53 cases; and no light perception (NLP) remained in 353 cases.Conclusions: Endoscopic optic nerve decompression (EOND) combined with corticosteroids or corticosteroids alone could reach the improvement for patients with TON. The EOND combined with corticosteroids could achieve better VA improvement in patients with NLP.

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“…12 Conventionally, this imaging technique can be used for the detection of a hematoma or bony fragments impinging on the optic nerve, which is useful in surgical management. 6,10,11 In the era of patient-speci c information, the investigation of orbital volume is becoming a fundamental requirement. For example, orbital volume is clearly one of the most helpful tools for estimating enophthalmos.…”

Section: Introductionmentioning

confidence: 99%

“…In these patients, imaging is frequently performed to clarify the extension of head or maxillofacial injury. 11 Computed tomography (CT) is the most accessible method for detecting neurological and maxillofacial problems, including orbital conditions. 12 Conventionally, this imaging technique can be used for the detection of a hematoma or bony fragments impinging on the optic nerve, which is useful in surgical management.…”

Section: Introductionmentioning

confidence: 99%

Effect Of Orbital Volume In Unilateral Orbital Fracture On Traumatic Optic Neuropathy

Senarak¹,

Yongvikul

et al. 2022

Preprint

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Purpose: This retrospective study aimed to analyze the relationship between the volume of the fractured and the normal orbit in patients with unilateral orbital fractures with and without traumatic optic neuropathy (TON).Subjects: Data of 25 patients with unilateral orbital fractures who underwent computer tomography between January 2016 and December 2020 were investigated. Emergency imaging was performed within 2 h of arrival at the emergency room. The subjects were categorized into two groups: unilateral orbital fractures with and without TON. Methods and Measures: The assessment of TON was performed during a comprehensive ophthalmologic examination by an ophthalmologist. The stereographic orbit was reconstructed and the volume was calculated. Other variables examined included age, sex, and cause of orbital trauma. The variables were compared using paired t-tests. Statistical significance was set at p < 0.05.Results: The orbital volume of the non-fractured orbit was 27.50 ± 2.26 and 27.48 ± 2.64 cm3 in the groups with and without TON, respectively. The average volume of the fractured orbit in the TON group was 27.78 ± 2.56 cm3, and there was no significant volumetric difference between the fractured and non-fractured sides in this group. However, the average volume of the fractured orbit without TON was 28.76 ± 3.18 cm3, larger than that of the non-fractured orbit (p=0.016).Conclusions: Non-expansion of the fractured orbit was a risk factor for indirect TON in patients with unilateral orbital fractures. Volumetric analysis from primary imaging would expedite the diagnosis and treatment of TON, resulting in optimal outcomes.

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Traumatic Optic Neuropathy

Cited by 15 publications

References 64 publications

Traumatic Optic Neuropathy: Analysis of Demographic and Clinical Parameters Over Three Years in a Tertiary Care Hospital in India

Traumatic Optic Neuropathy: Analysis of Demographic and Clinical Parameters Over Three Years in a Tertiary Care Hospital in India

The outcome of surgical and non-surgical treatments for traumatic optic neuropathy: a comparative study of 685 cases

Effect Of Orbital Volume In Unilateral Orbital Fracture On Traumatic Optic Neuropathy

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