Optic canal decompression in traumatic optic neuropathy

Journal of Neuro-ophthalmology, 1994

Is optic canal decompression still a viable option in traumatic optic neuropathy?

Neuro-Ophthalmology, 2014

IOSR Journals , 2019

BACKGROUD: Traumatic optic neuropathy (TON) refers to an acute injury of the optic nerve secondary to trauma. The optic nerve axons may be damaged either directly or indirectly and the visual loss may be partial or complete. Optic nerve decompression with steroids or surgical interventions or both has therefore been advocated as a means of improving visual prognosis in TON.OBJECTIVES:The aim of the study is to retrospectively analyse the most common cause ,age group ,gender,fracturerate,presenting visual acuity and postmedicaltreatment visual acuity.METHODS: Inclusion criteria:isolated traumatic optic neuropathy with atleast one follow up visit.A retrospective study of 50 patients with isolated traumatic optic neuropathy with atleast one followup was done.They were given iv methylprednisolone,iv steroids and oral steroids and tab.methycobalamine based on severity at the time of presentation.RESULTS:Most common gender affected were males(98%) than females.Most common age group was 33yrs(range 4yrs to 66yrs) and cause was roadtraffic accident around 81.6%,fracture rate about 53%.Left eye was most commonly affeceted (around 60.4%).22% presented with vision with No PL,24% from PL+ to ( ½)/60,20% with vision 1/60 to 5/60,27% presented with vision ranging 6/60 to 6/9,6% with 6/6.Post treatment vision ranged:10%-NO PL,24%-PL+ to (½)/60,24%-1/60 to5/60,18%-6/60 to 6/9,22%-6/6

Caspian Journal of Neurological Sciences (CJNS), 2024

Traumatic optic neuropathy (TON) is a rare that causes severe visual impairment usually results from cranial or ocular trauma. TON manifests directly and indirectly, which is more common. The incidence rate ranges from 0.7% to 2.5%. Clinical indicators of TON include the presence of an afferent pupillary defect after trauma, decreased vision acuity and intact ocular structure. Surgical decompression appears to be a feasible option in cases with direct bone compression on the optic nerve or progressive vision impairment in indirect TON. However, the evidence supporting treatment efficacy for improvement in vision is still ambiguous. This review will examine surgical techniques for decompressing the optic canal.

KESANS : International Journal of Health and Science, 2022

TON or traumatic optic neuropathy is a condition that can cause blindness which can be caused by trauma to the orbital area or head trauma. In its classification, TON is divided into two, namely direct and indirect. Direct TON or direct TON, is usually caused by a decrease or loss of a person's visual ability and the chance of recovery is smaller than indirect TON. This direct TON usually occurs when the optic nerve is laced with surrounding bone or the cause can be anatomical structural abnormalities. TON treatment can be done in two ways (1) Treatment with high doses of corticosteroids (2) with surgery.

European Archives of Oto-Rhino-Laryngology, 1999

Optic nerve decompression is a procedure that is now receiving increasing clinical attention. However, there are currently no standardized treatment protocols in the therapy of traumatic or pressure insults to the nerve. The present retrospective study was designed to report our experience with microscopic endonasal transethmoid-sphenoid optic nerve decompression in 24 unilateral trauma cases and 11 unilateral skull base tumor patients. In general preoperative visual acuities in the trauma patients were worse than in the tumor patients. Following surgery, 9 of 11 tumor patients (82%) had at least some improvement of their vision, including 5 complete recoveries. In the group with traumatic visual impairment, 16 of the patients had no light perception preoperatively. Postoperatively, 13 patients (54%) had at least some improvement, with 4 patients regaining normal or near normal vision. Compared to other techniques and approaches, our technique is a minimally invasive procedure for optic nerve decompression, reducing unnecessary operative trauma to nasal structures, skin incisions or even craniotomy and frontal lobe retraction.

World of Medicine and Biology, 2017

The neurohumoral properties's changes in the hypothalamus as a result of TON are unknown. The purpose of the study: to study neurohumoral dysfunction in the traumatic optical neuropathy's pathogenesis. Methods. The traumatic damage to the orbital part of the right optic nerve was reproduced in 60 sexually mature rabbits in the experiment. There were two groups of animals of 30 individuals: intact and experimental. Electronic microscopy of the hemithin and ultrathin sections and the morphometry of the cranial part of the right optic nerve and the suprachismic nucleus of the hypothalamus one month after the injury. It has been established that traumatic damage to the orbital part of the optic nerve causes reactive edema and destructive changes in the cranial part of the optic nerve and the suprachiasmic nucleus of the hypothalamus. The reducing the volumetric neurosecretory granules density and the pycnomorphic cells' number at the last stage of development increasing were detected. This reduces the corticosteroids production that cause inflammatory reactive damage to the optic nerve. Conclusion. Hence, neurohumoral dysfunction is an important mechanism for the pathogenesis of traumatic optical neuropathy, and its correction will have positive effects for treatment.

JAMA ophthalmology, 2014

Current controversy about the primary treatment of traumatic optic neuropathy (TON) has anchored on final vision following injury, but, to our knowledge, no study has examined the effect of different treatments on regaining and protecting optic nerve reserve or on the outcome of second optic nerve injuries. To assess vision improvement in patients treated by various methods who have a second incidence of TON. Retrospective medical record review of 12 patients with a second TON seen in an 18-year period (mean follow-up, 11.3 months) at a single tertiary care oculoplastic practice. Observation, high-dose corticosteroids, optic nerve decompression, or high-dose corticosteroids plus optic nerve decompression. Change in vision on the Snellen eye chart. RESULTS All second TON events involved the same-side optic nerve as initially injured, and with observation alone, corticosteroids, or corticosteroids and partial optic canal decompression, all patients had vision improvement after their i...

Otolaryngology - Head and Neck Surgery, 2006