Asswss the effects of high-dose steroids in the management of traumatic optic neuropathy

This study was carried out in 47patients (47 eyes) with traumatic optic neuropathy admitted Cho Ray Hospital from March 2003 to March 2004, among them 39 cases were treated by high-dose corticoids. The percentage of traumatic optic neuropathy was 0.32% of all head trauma cases. Among 47 patients, there were 44 males, 3 females, mean age: 30 years old, lesions were in 18 right eyes and 29 left eyes, traffic accidents were in 46 cases (97.9%), mainly were motorcycle accidents. The mean duration for finding lesions is 20 hours and mean duration for treating is 37 hours. Visual acuity was severely decreased: 76.6% patients with no light perception, 85% patients with no light perception and light perception. Concomitant traumas included injuries in ear, nose and throat trauma (51.1%), teeth (40.4%), head (38.3%). CT scan finding revealed fractures of orbit in 19 cases (40.4%), of optic canal in 6 cases (15%). Treatment with high-dose corticoids (methyl-prednisolone IV 500mg-1999mg a day) for 39 cases had more effective than no treatment or low-dose corticoids (< 500mg) in 8 cases. The percentage of vision recovery in high-dose corticoid group was 38.5%, with 2 cases had complications of high glycaemia (5.1%). Early treatment within 8 hours after trauma could give higher rate of recovery. Prognostic factors for no recovery included vision acuity after trauma was no light perception, 4-grade soft tissue lacerations and no response after 48 hours of high-dose corticoids. In the optic neuropathy, the rate of vision recovery in high-dose corticoid group was 38.5%, and treating by high-dose corticoids had few complications, more effective than low-dose corticoids (p<0.05)

The application of OCT for diagnosis of central serous chorioretinopathy

In the study, 25 consecutive eyes of 25 patients (21 men, 4 women; mean age: 45 ± 8.5 years; range 30 to 58 years) with central serous chorioretinopathy were examined with optical coherence tomography (OCT) during acute phase and after the resolution of the retinal detachment. Cross-sectional retinal images through the center of the fovea were obtained from all eyes by OCT. The retinal thickness at the fovea center was measured. All of patients were conducted fluorescent angiographies. In the acute phase, neurosensory retina was thickened within the area of serous retinal detachment in all 25 eyes. The retinal thickness at the center of the fovea during the acute phase (range, 162 to 273µm; mean ± SD, 192 ±18 µm) was significantly thickened in comparison with that after resolution (range, 98 to 149 µm; mean± SD, 117±12.7µm). The retinal pigment epithelium was focally detached in five eyes