Traumatic Optic Neuropathy
Visual Outcome Following Combined Therapy Protocol
M. G. Rajiniganth, MS;
Ashok K. Gupta, MS, MNAMS;
Amod Gupta, MS;
Jayapalli Rajiv Bapuraj, MS, PDCC
Arch Otolaryngol Head Neck Surg. 2003;129:1203-1206.
Objective To assess the visual outcome in cases of traumatic optic neuropathy treated with a combined therapy protocol of methylprednisolone injections and endoscopic optic nerve decompression.
Design Prospective, nonrandomized study.
Setting Academic tertiary care referral center.
Patients The study included 44 patients with posttraumatic indirect optic nerve injury.
Main Outcome Measure Visual acuity.
Results Visual improvement was achieved in 31 patients (70%) when treatment was initiated within 7 days of injury, whereas only 10 patients (24%) showed improvement when the treatment was started after more than 7 days. The time lapse after injury and treatment, degree of visual loss, and computed tomographic evidence of canalicular and pericanalicular fractures were found to be significant prognostic factors.
Conclusions Endoscopic optic nerve decompression is a minimally invasive procedure that does not cause any adverse cosmetic effects. The risk-benefit ratio suggests that the combined therapy protocol of methylprednisolone injections and endoscopic optic nerve decompression results in a better visual outcome, without any major risks.
From the Departments of Otorhinolaryngology and Head and Neck Surgery (Drs Rajiniganth and A. K. Gupta), Ophthalmology (Dr A. Gupta), and Radiodiagnosis (Dr Bapuraj), Postgraduate Institute of Medical Education and Research, Chandigarh, India. The authors have no relevant financial interest in this article.
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