Traumatic Optic Neuropathy: Update on Management

Siyanaki, Mohammad Reza Hosseini; Azab, Mohammed; Lucke‐Wold, Brandon

doi:10.3390/encyclopedia3010007

Cited by 5 publications

(4 citation statements)

References 115 publications

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“…), extraocular (optic nerve) abnormalities (optic neuritis/ neuropathy), and brain abnormalities (brain tumors, stroke, etc.). Although rare in Japan, traumatic eye injury, ocular hemorrhage and ophthalmorrhea, damage to the optic tract and optic nerve, and traumatic brain injury are also considered possible causes [5,6]. In this study, we focused on acute vision loss caused by nasal sinus disease.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, retinal microglia are activated by optic nerve damage and produce inflammatory cytokines, chemokines, and reactive oxygen species. These factors are thought to cause the accumulation of inflammatory substances in the optic nerve, which eventually leads to permanent vision loss [6]. Prolonged pressure from the mucocele is thought to cause thinning of the bone and direct pressure on the optic nerve, resulting in impaired blood flow [10].…”

Section: Discussionmentioning

confidence: 99%

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Clinical Evaluation of Acute Rhinogenic Visual Disturbances

Akutsu¹,

Tsunemi²

2023

J Otolaryngol Res & Rep

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Objective: To Analyze the time to treatment and visual prognosis of patients who presented with visual disturbance caused by sinus disease. Methods: We retrospectively analyzed the post-surgery clinical course and visual acuity of 23 patients (24 sides) with rhinogenic visual disturbances from Dokkyo Medical University, Tochigi, Japan. Sinus diseases were classified into three groups: infection/inflammation (7 patients), mucocele (8 patients [9 sides]), and tumor (8 patients). Results: Most patients (68%) were first admitted to the ophthalmology department and then referred to us. Patients with eye pain and ocular swelling were examined before those without symptoms (p < 0.05). In particular, the infection/inflammation group was more likely to present with symptoms other than vision loss and thus visit the rhinologists earlier. The infection/inflammation and mucocele groups showed improvement in visual acuity after surgery (p < 0.05). Conclusions: Early consultation and surgical treatment were shown to be effective in the infection/inflammation and mucocele groups. For early rhinologist consultation, imaging studies should be performed for accurate diagnosis. Patients should be educated about the disease and encouraged to seek correct medical attention as early as possible.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of Acute Rhinogenic Visual Disturbances

Akutsu¹,

Tsunemi²

2023

J Otolaryngol Res & Rep

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“…The current clinical management of optic neuropathy primarily aims to control disease-associated risk factors, such as elevated intraocular pressure, and slow down disease progression [ 95 – 97 ]. However, advancements in high-throughput assays, coupled with parallel computing and bioinformatics algorithms, now enable the generation of comprehensive system-wide profiles of disease processes and molecular targets.…”

Section: Discussionmentioning

confidence: 99%

Activation of multiple Eph receptors on neuronal membranes correlates with the onset of optic neuropathy

Strong,

Esquivel,

Wang

et al. 2023

Eye and Vis

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Background Optic neuropathy is a major cause of irreversible blindness, yet the molecular determinants that contribute to neuronal demise have not been fully elucidated. Several studies have identified ‘ephrin signaling’ as one of the most dysregulated pathways in the early pathophysiology of optic neuropathy with varied etiologies. Developmentally, gradients in ephrin signaling coordinate retinotopic mapping via repulsive modulation of cytoskeletal dynamics in neuronal membranes. Little is known about the role ephrin signaling plays in the post-natal visual system and its correlation with the onset of optic neuropathy. Methods Postnatal mouse retinas were collected for mass spectrometry analysis for erythropoietin-producing human hepatocellular (Eph) receptors. Optic nerve crush (ONC) model was employed to induce optic neuropathy, and proteomic changes during the acute phase of neuropathic onset were analyzed. Confocal and super-resolution microscopy determined the cellular localization of activated Eph receptors after ONC injury. Eph receptor inhibitors assessed the neuroprotective effect of ephrin signaling modulation. Results Mass spectrometry revealed expression of seven Eph receptors (EphA2, A4, A5, B1, B2, B3, and B6) in postnatal mouse retinal tissue. Immunoblotting analysis indicated a significant increase in phosphorylation of these Eph receptors 48 h after ONC. Confocal microscopy demonstrated the presence of both subclasses of Eph receptors within the retina. Stochastic optical reconstruction microscopy (STORM) super-resolution imaging combined with optimal transport colocalization analysis revealed a significant co-localization of activated Eph receptors with injured neuronal cells, compared to uninjured neuronal and/or injured glial cells, 48 h post-ONC. Eph receptor inhibitors displayed notable neuroprotective effects for retinal ganglion cells (RGCs) after six days of ONC injury. Conclusions Our findings demonstrate the functional presence of diverse Eph receptors in the postnatal mammalian retina, capable of modulating multiple biological processes. Pan-Eph receptor activation contributes to the onset of neuropathy in optic neuropathies, with preferential activation of Eph receptors on neuronal processes in the inner retina following optic nerve injury. Notably, Eph receptor activation precedes neuronal loss. We observed a neuroprotective effect on RGCs upon inhibiting Eph receptors. Our study highlights the importance of investigating this repulsive pathway in early optic neuropathies and provides a comprehensive characterization of the receptors present in the developed retina of mice, relevant to both homeostasis and disease processes.

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“…Recovery is challenging in patients with direct TON because the optic nerve is directly lacerated, whereas those with indirect type have the chance to recover. [ 8 , 12 ] Especially for indirect TON, multiple therapeutic options have been proposed, including observation alone, high-dose steroids, surgical optic canal decompression (OCD), and their combinations. [ 4 ] However, the efficacy of these treatments has not been established, and no consensus exists regarding the optimal treatment for TON.…”

Section: Introductionmentioning

confidence: 99%

Visual-evoked potential predicts the efficacy of the optical canal decompression for traumatic optic nerve neuropathy showing blindness: A case report

Otsu¹,

Komaki²,

Takeshige³

et al. 2023

Surgical Neurology International

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Background: The indication for surgical optic canal decompression (OCD) for traumatic optic neuropathy (TON) remains controversial because there is no reliable predictor of a good outcome. We report the case of a blind patient with TON whose remaining visual-evoked potential (VEP) suggested recovery potential of the injured optic nerve after OCD. Case Description: A 48-year-old man had fallen from a height of 7 m, striking his head. He immediately complained of right-eye blindness. He had no light perception and the direct light reflex disappeared from the right pupil, although there was no fracture or traumatic lesion on computed tomography and magnetic resonance imaging. Because the amplitude of the VEP with the right eye stimulation remained unchanged, we performed the right OCD. During surgical OCD, the amplitude and latency of VEP began to improve. Finally, the visual field improved in almost all directions, and eyesight improved to 0.2. Conclusion: The retained VEP activity in TON may suggest the recovery potential of the injured optic nerve, even in cases of blindness. It is possible that VEP is an indicator of aggressive treatment for TON such as OCD.

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Traumatic Optic Neuropathy: Update on Management

Cited by 5 publications

References 115 publications

Clinical Evaluation of Acute Rhinogenic Visual Disturbances

Clinical Evaluation of Acute Rhinogenic Visual Disturbances

Activation of multiple Eph receptors on neuronal membranes correlates with the onset of optic neuropathy

Visual-evoked potential predicts the efficacy of the optical canal decompression for traumatic optic nerve neuropathy showing blindness: A case report

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