The Outcome of Endoscopic Optic Nerve Decompression for Bilateral Traumatic Optic Neuropathy.

Objective: To investigate the outcomes of endoscopic optic nerve decompression (EOND) for bilateral traumatic optic neuropathy (TON). Methods: A retrospective analysis was conducted in 5 patients with bilateral TON, between January 2003 and December 2013. All the patients underwent preoperative ophthalmological evaluation, flash visual-evoked potentials, computed tomography scan, and systemic corticosteroid therapy. All the patients required an EOND surgery, due to poor response to medical therapy, and the remainder one was only treated with corticosteroid due to operative contraindication. Results: Of the 5 patients (10 eyes) undergoing EOND, visual acuity improved in 30% of eyes (n = 3) with a mean follow-up of 3 months. The remainder 7 eyes still had no light perception. All of the 5 patients undergoing EOND had no operative complications. Conclusion: Treatment for bilateral TON should not be limited on the length of time to injury and visual-evoked potentials results. If surgical conditions permit and with no contraindications, patients should receive active surgical treatment as soon as possible. (C) 2017 by Mutaz B. Habal, MD.

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