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2015 ; 8
(1
): 31-41
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Traumatic optic neuropathy: a review
#MMPMID25709751
Kumaran AM
; Sundar G
; Chye LT
Craniomaxillofac Trauma Reconstr
2015[Mar]; 8
(1
): 31-41
PMID25709751
show ga
The aim of this article is to evaluate current literature on investigation and
management of traumatic optic neuropathy (TON), propose recommendations for
diagnosis and management, and explore novel future treatments. TON, though
uncommon, causes substantial visual loss. Without clear guidelines, there is much
ambiguity regarding its diagnosis and management. Investigation and treatment
(conservative, medical, surgical, and combined) vary widely between centers.
Electronic databases PubMed, MEDLINE, PROSPERO, CENTRAL, and EMBASE were searched
for content that matched "Traumatic optic neuropathy." Articles with abstracts
and full text available, published in the past 10 years, written English and
limited to human adults, were selected. All study designs were acceptable except
case reports and case series with fewer 10 patients. All abstracts were then
evaluated for relevance. References of these studies were evaluated and if also
relevant, included. A total of 2,686 articles were retrieved and 43 examined for
relevance. Of these, 23 articles were included. TON is a clinical diagnosis.
Visual-evoked potential is useful in diagnosis and prognosis. Computed tomography
demonstrates canal fractures and concomitant injuries. Magnetic resonance images
should be reserved for select and stable patients. Conservative treatment is
appropriate in mild TON. Steroids are of questionable benefit and may be harmful.
Surgery should be reserved for patients with radiological evidence of compression
and individualized.
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