Visual prognosis after indirect traumatic optic neuropathy

Abstract

Objective: To investigate a possible correlation between final visual acuity and the presence at baseline of various systemic and local (orbital/ocular) signs in patients affected by indirect traumatic optic neuropathy. Methods: 35 cases of traumatic optic neuropathy were examined retrospectively and 13 variables were tested. Univariate analysis with "no recovery of visual acuity" as the primary outcome was performed. Relative risk (RR) and 95% confidence intervals (CI) were calculated. Fisher's exact test was used for two variables to test differences between proportions. Results: Four variables showed a significantly increased risk for no recovery of visual acuity: presence of blood within the posterior ethmoidal cells (RR = 2.25, 95% CI 1.25 to 4.04); age over 40 years (RR = 1.79, 1.07 to 2.99); loss of consciousness associated with traumatic optic neuropathy (RR = 2.21, 1.17 to 4.16); and absence of recovery after 48 hours of steroid treatment (p < 0.01, Fisher's exact test). Recovery documented at the first follow up visit after treatment was significantly associated with recovery at the last follow up visit (p < 0.01, Fisher's exact test). Conclusions: These four negative prognostic signs in patients affected by traumatic optic neuropathy may be useful in predicting the visual outcome in patients developing visual loss after head trauma and in deciding on the need for surgical treatment.

High-dose intravenous methylprednisolone in recent traumatic optic neuropathy; a randomized double-masked placebo-controlled clinical trial

“…In our study, visual recovery in the first 48 h was a prognostic factor for final visual acuity. This result is the same as in a study by Carta et al [4]. In our study, high initial RAPD was related to reduced final visual improvement.…”

Incidence of Traumatic Optic Neuropathy In Closed head trauma-Review of literature.

“…DOI: 10.9790/0853-1509104750 www.iosrjournals.org 48 | Page Exclusion Criteria: [1]. Patients having head trauma with penetrating injuries of eye ball, [2].…”

“…The most common form of traumatic optic neuropathy is indirect damage to the optic nerve and has been reported following 0.5% to 5% of all closed head trauma [1], [2] . It is defined as traumatic visual loss which occurs without initial ophthalmoscopic evidence of injury to the eye ball or optic nerve.…”

A Clinical Study of Optic Atrophy - Its Aetiology, Pathogenesis, Clinical Manifestations, Management and Visual Outcome

“…Visual prognosis depends upon etiology, stage of the disease and also on the time and effectiveness of management of the cause. 9,10 Glaucomatous blindness can be prevented by early diagnosis and treatment which can stop the progression of the disease. Retinitis Pigmentosa has no effective treatment till date, and its incidence be reduced by genetic counselling, discouraging consanguineous marriages and limitation of number of off-spring in married individuals with RP.…”