Risk Factor Analysis for the Outcomes of Indirect Traumatic Optic Neuropathy with No Light Perception at Initial Visual Acuity Testing.

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Risk Factor Analysis for the Outcomes of Indirect Traumatic Optic Neuropathy with No Light Perception at Initial Visual Acuity Testing.

World Neurosurg. 2018 Apr 26;:

Authors: Lai IL, Liao HT

Abstract
BACKGROUND: The optimal management of indirect traumatic optic neuropathy (TON) is controversial. We aimed to compare the differences in visual improvement by treatment option in patients presenting with TON and no light perception (NLP). We also wanted to identify any patient-related factors that might favor the use of SPT or OND.
MATERIAL AND METHODS: We retrospectively identified 46 consecutive patients with indirect TON treated at Chang Gung Memorial Hospital between 2007 and 2015. The outcome was the improvement in visual acuity by improvement rate and degree of improvement.
RESULTS: Females had a much better improvement rate than males. Compared with delayed treatment, patients receiving SPT within 14 hours or receiving OND within 26 hours had a better improvement rate/degree. In patients with an initial intra-ocular pressure (IOP,17-23 mmHg),the improvement rate/degree were significantly better than for patients with an IOP outside this range. For patients treated by OND, an initially normal IOP (IOP, 11-21 mmHg) suggested a significantly better prognosis in the improvement rate/degree.
CONCLUSIONS: For patients with indirect TON, initial NLP implies a poor prognosis, but SPT or OND are both feasible treatment options. This results also emphasize the importance of timely treatment for patients with indirect TON and NLP. It was notable that females and patients with an initial IOP (17-23 mmHg) were more likely to recover. The results of our study indicate that normal initial IOP (11-21 mmHg) is good prognostic factor for indirect TON patients treated with OND.

PMID: 29705230 [PubMed - as supplied by publisher]

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