Endoscopic optic nerve decompression for traumatic blindness.
OBJECTIVE
The goal of this study was to compare the outcome of patients with traumatic optic neuropathy (TON) treated with high-dose steroids with the outcome of patients with TON treated with endoscopic optic nerve decompression (EOND) after failing high-dose steroid treatment.


METHODS
During this retrospective review of patients with TON seen from 1994 to 1998, all patients were first treated with megadose methylprednisolone for 48 hours. Patients with no improvement or with worsening visual acuity were offered EOND.


RESULTS
Eleven of 34 (32%) patients treated with high-dose steroids showed improvement, and 23 (68%) did not. Seventeen of the 23 patients without improvement after high-dose steroid treatment underwent EOND. Fourteen of 17 (82%) surgically treated patients had improved visual acuity, and 3 (18%) did not, with an overall improvement in 25 of 34 (74%) patients (chi(2) = 11. 338, P = 0.0007).


CONCLUSIONS
EOND is an appropriate treatment technique for patients with TON in whom high-dose steroid treatment has failed.
Kountakis
S E
SE
Department of Otolaryngology-Head and Neck Surgery, University of Virginia Medical School, Charlottesville, VA 22906-0008, USA.
Maillard
A A
AA
El-Harazi
S M
SM
Longhini
L
L
Urso
R G
RG
D000293:Adolescent; D000328:Adult; D000368:Aged; D001766:Blindness / Q000601:surgery*; D019299:Decompression, Surgical; D004305:Dose-Response Relationship, Drug; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D020221:Optic Nerve Injuries / Q000601:surgery*; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects
D005938:Glucocorticoids; D008775:Methylprednisolone