title: Outcome for traumatic optic neuropathy--surgical versus nonsurgical treatment.
abstract: This study was performed to identify factors that can affect the final outcome and to recognize the proper management for patients with traumatic optic neuropathy (TON). This retrospective study included 42 consecutive patients with TON after maxillofacial trauma. Megadose methylprednisolone was administered to all patients during the first 3 days after diagnosis. Twenty-four patients received treatment with megadose steroids combined with optic nerve decompression and the remaining 18 with megadose methylprednisolone alone. Initial visual acuity (IVA) was the statistically significant factor affecting the outcome of TON (P = 0.006 for improvement rate). Patients treated within 7 days after injury had a better improvement degree, P = 0.056. Patients in a surgical group with an IVA of no light perception (NLP) had a better improvement rate and degree (31.3%; 59.34 +/- 22.18%) than those in nonsurgical group (0%, 0%; P = 0.272). Initial visual acuity is the critical factor that affects the outcome of TON. Surgical optic nerve decompression is considerable in maxillofacial trauma patients with an IVA of NLP.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Wen-Guei
authors.initials: WG
authors.lastname: Yang
authors.forename: Chien-Tzung
authors.initials: CT
authors.lastname: Chen
authors.forename: Pei-Kwei
authors.initials: PK
authors.lastname: Tsay
authors.forename: Glenda H
authors.initials: GH
authors.lastname: de Villa
authors.forename: Yueh-Ju
authors.initials: YJ
authors.lastname: Tsai
authors.forename: Yu-Ray
authors.initials: YR
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D002648:Child; D019299:Decompression, Surgical; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008446:Maxillofacial Injuries / Q000150:complications*; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D020221:Optic Nerve Injuries / Q000188:drug therapy* / Q000601:surgery*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone