Traumatic optic neuropathy: visual outcome following combined therapy protocol.
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.


METHODS
Prospective, nonrandomized study.


METHODS
Academic tertiary care referral center.


METHODS
The study included 44 patients with posttraumatic indirect optic nerve injury.


METHODS
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.
Rajiniganth
M G
MG
Department of Otorhinolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Gupta
Ashok K
AK
Gupta
Amod
A
Bapuraj
Jayapalli Rajiv
JR
D000328:Adult; D003131:Combined Modality Therapy; D019299:Decompression, Surgical; D004724:Endoscopy; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D020221:Optic Nerve Injuries / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
D005938:Glucocorticoids; D008775:Methylprednisolone