Chayapol Ardsungnoen

Sittichai Tantipasawasin

Keywords :

traumatic optic neuropathy, steroid

Abstract :

This study aimed to investigate treatment outcome of corticosteroid and observation for
traumatic optic neuropathy. The retrospective study was performed in Chonburi Hospital. Treatment
method, initial visual acuity and visual acuity at 1 month posttreatment were collected. Patients
were divided by treatment methods into 2 groups, observation group and steroid group. The chi-square
test was used to determine relationship between treatment method and improvement of visual
acuity. For the result 53 patient were included. Mean of initial visual acuity of corticosteroid group
was -2.61(± 0.37) and observation group was -2.58(± 0.45). There were 55.6% and 46.2% patients
that had improvement of visual acuity in corticosteroid and observation group, but this difference
was not statistically significant. For conclusions, there was no significant relationship between
treatment by corticosteroid or observation alone for improvement of visual acuity at one month
in traumatic optic neuropathy.

References :

Steinsapir KD, Goldberg RA. Traumatic optic neuropathy. Surv Ophthalmol.
1994;38:487-518.

Finger RP, Fenwick E, Marella M, Dirani M, Holz FG, Chiang PP, et al. The impact of vision impairment on vision-specific quality of life in Germany. Invest Ophthalmol Vis Sci. 2011;52:3613-9.

Fague L, Liu YA, Marsh-Armstrong N. The basic science of optic nerve regeneration.
Ann Transl Med. 2021;9:1276.

Benowitz LI, Yin Y. Optic nerve regeneration. Arch Ophthalmol. 2010;128:1059-64.

Bracken MB, Shepard MJ, Collins WF, Holford TR, Young W, Baskin DS, et al.
A randomized, controlled trial of methylprednisolone or naloxone in the treatment of
acute spinal-cord injury. Results of the Second National
Acute Spinal Cord Injury Study. N Engl J Med. 1990;322:140511.

Levin LA, Beck RW, Joseph MP, Seiff S, Kraker R. The treatment of traumatic optic neuropathy:
the International Optic Nerve Trauma Study. Ophthalmol. 1999;106:1268-77.

Entezari M, Rajavi Z, Sedighi N, Daftarian N, Sanagoo M. High-dose intravenous
methylprednisolone in recent traumatic optic neuropathy; a randomized double-masked
placebo-controlled clinical trial. Graefes Arch Clin Exp Ophthalmol. 2007;245:1267-71.

Alderson P, Roberts I. Corticosteroids for acute traumatic brain injury.
Cochrane Database Syst Rev. 2005;2005(1): Cd000196.

Sauerland S, Nagelschmidt M, Mallmann P, Neugebauer EA. Risks and benefits of
preoperative high dose methyl prednisolone in surgical patients: a systematic review.
Drug Saf. 2000;23:449-61.

Chuenkongkaew W, Chirapapaisan N. A prospective randomized trial of megadose
methylprednisolone and high dose dexamethasone for traumatic optic neuropathy.
J Med Assoc Thai. 2002;85:597-603.

Lin J, Hu W, Wu Q, Yi J, Liu Z, Zhou G, et al. Analysis of prognostic factors for the indirect
traumatic optic neuropathy underwent endoscopic transnasal optic canal decompres
sion. J Craniofac Surg. 2020;31:1266-9.

Yan W, Chen Y, Qian Z, Selva D, Pelaez D, Tu Y, et al. Incidence of optic canal fracture in
the traumatic optic neuropathy and its effect on the visual outcome. Br J Ophthalmol.
2017;101:261-7.

Lessell S. Indirect optic nerve trauma. Arch Ophthalmol. 1989;107:382-6.

Lee KF, Muhd Nor NI, Yaakub A, Wan Hitam WH. Traumatic
optic neuropathy: a review of 24 patients. Int J Ophthalmol. 2010;3:175-8.

Kitthaweesin K. Optic nerve injury in Srinagarind Hospital. Srinagarind Med J. 1997;12(4):6.

Kountakis SE, Maillard AA, El-Harazi SM, Longhini L, Urso RG. Endoscopic optic nerve
decompression for traumatic blindness. Otolaryngol Head Neck Surg. 2000;123(1 Pt 1):34-7.

Li HB, Shi JB, Cheng L, Yun O, Xu G. Salvage optic nerve decompression for traumatic
blindness under nasal endoscopy: risk and benefit analysis. Clin Otolaryngol. 2007; 32:447-51.

Thai Road Safety Collaboration. Morbidity and mortality data of the compulsory motor
insurance, 2021 [cited 2023 Apr 30]. Available from: http://www.thairsc.com/p77/index.
htm?provid=20.

Anderson RL, Panje WR, Gross CE. Optic nerve blindness following blunt forehead trauma.
Ophthalmol. 1982;89: 445-55.

Rajiniganth MG, Gupta AK, Gupta A, Bapuraj JR. Traumatic optic neuropathy: visual
outcome following combined therapy protocol. Arch Otolaryngol Head Neck Surg.
2003;129:1203-6.

Kelishadi SS, Zeiderman MR, Chopra K, Kelamis JA, Mundinger GS, Rodriguez ED.
Facial fracture patterns associated with traumatic optic neuropathy. Craniomaxillofac
Trauma Reconstr. 2019;12:39-44.

Huempfner-Hierl H, Bohne A, Wollny G, Sterker I, Hierl T. Blunt forehead trauma and
optic canal involvement: finite element analysis of anterior skull base and orbit
on causes of vision impairment. Br J Ophthalmol. 2015;99: 1430-4.

Zhang X, Lee Y, Olson D, Fleischman D. Evaluation of optic canal anatomy and
symmetry using CT. BMJ Open Ophthalmol. 2019;4:e000302.

Steinsapir KD, Goldberg RA, Sinha S, Hovda DA. Methylprednisolone exacerbates
axonal loss following optic nerve trauma in rats. Restor Neurol Neurosci. 2000;17:157-63.

Yu-Wai-Man P, Griffiths PG. Steroids for traumatic optic neuropathy.
Cochrane Database Syst Rev. 2013;2013(6): Cd006032.

Teerittikul N. Prognostic factors in traumatic optic neu-ropathy patients in
Khon Kaen Hospital. Mahasarakham Hosp J. 2021;18(2):8.

Carta A, Ferrigno L, Leaci R, Kosmarikou A, Zola E, Gomarasca S. Long-term outcome
after conservative treatment of indirect traumatic optic neuropathy. Eur J Ophthalmol.
2006;16:847-50.