Treatment of Optic Canal Decompression Combined with Umbilical Cord Mesenchymal Stem (Stromal) Cells for Indirect Traumatic Optic Neuropathy: A Phase 1 Clinical Trial

Li, Jia; Bai, Xu; Guan, Xiaoyue; Yuan, Hongfeng; Xu, Xiang

doi:10.1159/000512469

Cited by 6 publications

(4 citation statements)

References 24 publications

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“…Optic canal decompression with mesenchymal stem cell implantation compared to optic canal decompression alone. Both groups showed significant improvements in vision compared with the baseline; however, there was no statistically significant difference between the study groups [62].…”

Section: Experimental Treatmentsmentioning

confidence: 71%

Traumatic Optic Neuropathy

Klein¹,

Wahbi²

2022

Frontiers in Traumatic Brain Injury

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Traumatic optic neuropathy (TON) is a specific neurological sequence of traumatic brain injury (TBI). It has a different mechanism than other most neurologic complications of head trauma and its consequences can be devastating. The damage can be from direct penetrating trauma or bone fracture injuring the optic nerve directly or secondary to indirect blunt trauma (usually causing traction). The diagnosis of TON is based on the clinical history and examination findings indicative of optic neuropathy, especially the presence of defective pupillary light response. TON can cause only mild vision loss but, in some cases, severe vision loss is present. Imaging findings can support the diagnosis, and provide information on the mechanism as well as treatment options. The treatment options include observation alone, systemic steroids, erythropoietin, surgical decompression of the optic canal, or combination. The evidence base for these various treatment options is controversial and each treatment has its side effects and risks. Poor prognostic factors include poor visual acuity at presentation, loss of consciousness, no improvement in vision in the first 48 hours, and evidence of optic canal fractures on neuroimaging.

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Section: Experimental Treatmentsmentioning

confidence: 71%

Traumatic Optic Neuropathy

Klein¹,

Wahbi²

2022

Frontiers in Traumatic Brain Injury

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“…Twenty patients with TON were enrolled in a single-center, prospective study; group 1 received MSC local implantation with optic canal decompression; group 2 received optic canal decompression alone. There was no significant difference between groups 1 and 2 in terms of best-corrected visual acuity at follow-up ( p > 0.05); However, group 1 had a better visual result than group 2 [ 110 ].…”

Section: Experimental Treatmentsmentioning

confidence: 99%

Traumatic Optic Neuropathy: Update on Management

2023

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Traumatic optic neuropathy is one of the causes of visual loss caused by blunt or penetrating head trauma and is classified as both direct and indirect. Clinical history and examination findings usually allow for the diagnosis of traumatic optic neuropathy. There is still controversy surrounding the management of traumatic optic neuropathy; some physicians advocate observation alone, while others recommend steroid therapy, surgery, or both. In this entry, we tried to highlight traumatic optic neuropathy’s main pathophysiologic mechanisms with the most available updated treatment. Recent research suggests future therapies that may be helpful in traumatic optic neuropathy cases.

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“…3 Presently, despite the controversy, optic nerve canal decompression is one of the main strategies for treating traumatic optic neuropathy. 1,4,5 As the clinical application of endoscopic technologies continues to mature, the endoscopic transnasal approach has gradually become the routine approach for optic canal decompression in neurosurgery. [6][7][8][9] To improve the success rate of the transethmoid-sphenoid endoscopic approach for optic canal decompression and provide a reference for its clinical promotion, we performed an anatomical study of optic canal decompression performed using the transethmoid-sphenoid endoscopic approach and reviewed the clinical data of 10 patients (11 eyes) who underwent optic canal decompression via this approach.…”

mentioning

confidence: 99%

“…The pathophysiological mechanism of traumatic optic neuropathy is more complex, and the occurrence, as well as the development of optic nerve injury, is a process involving multiple factors, which are generally classified into primary and secondary depending on the cause of the injury 3. Presently, despite the controversy, optic nerve canal decompression is one of the main strategies for treating traumatic optic neuropathy 1,4,5. As the clinical application of endoscopic technologies continues to mature, the endoscopic transnasal approach has gradually become the routine approach for optic canal decompression in neurosurgery 6–9.…”

mentioning

confidence: 99%

Anatomical Study and Clinical Application of Optic Canal Decompression Via Transethmoid-sphenoid Approach Under Endoscope

Wang

Zhang

She

et al. 2023

Journal of Craniofacial Surgery

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This study aimed to evaluate the safety and accuracy of the endoscopic transethmoid-sphenoid approach for optic canal decompression. Twelve sides of 6 adult cadaveric heads fixed in formalin were selected to simulate optic canal decompression using the endoscopic transethmoid-sphenoid approach. Furthermore, this approach was used for optic canal decompression in 10 patients (11 eyes) with optic nerve canal injury. Related anatomical structures were observed using a 0-degree endoscope, and the anatomical characteristics as well as the surgical data were collected. The maximum effective widths of the cranial opening, orbital opening, and middle segment of the canal that could be drilled open endoscopically were 7.82±2.63, 8.05±2.77, and 6.92±2.01 mm, respectively. The angle between the line linking the center point of the tubercular recess with the midpoint of the cranial opening of the optic canal and the horizontal coordinate was 17.23±1.34 degrees. At the orbital opening of the optic canal, the ophthalmic artery was located directly inferior to the optic nerve in 2 cases (16.7%) and laterally inferior to the optic nerve in 10 cases (83.3%). Six of the operational eyes were effective while the remaining 5 were ineffective. No postoperative complications such as bleeding, infection, or cerebrospinal fluid leakage were observed during the follow-up period (6–12 mo). In conclusion, optic canal decompression positively impacts the prognosis of partial traumatic optic neuropathy. Furthermore, the endoscopic transethmoid-sphenoid approach for optic canal decompression is a minimally invasive procedure that provides direct access and adequate decompression. This technique is easy to master and suitable for clinical applications.

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Treatment of Optic Canal Decompression Combined with Umbilical Cord Mesenchymal Stem (Stromal) Cells for Indirect Traumatic Optic Neuropathy: A Phase 1 Clinical Trial

Cited by 6 publications

References 24 publications

Traumatic Optic Neuropathy

Traumatic Optic Neuropathy

Traumatic Optic Neuropathy: Update on Management

Anatomical Study and Clinical Application of Optic Canal Decompression Via Transethmoid-sphenoid Approach Under Endoscope

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