Clinical Evaluation of the Traumatic Optic Neuropathy

ABSTRACT

Traumatic optic neuropathy is one of true ophthalmic emergencies and there is no proven form of treatment for traumatic optic neuropathy. 82 cases of traumatic optic neuropathy were investigated to evaluate the effectiveness of high dose corticosteroid for the visual improvement. Age, sex, initial visual acuity, final visual acuity, interval to treatment, the type of trauma and the affected region were studied retrospectively.250 mg of Methylprednisolone was administered intravenously every 6 hours for 3 days, and then followed by tapering using oral prednisone The vision was improved in 36 of 82 cases[43.9%]. It was difficult to interpret the relation-ships between the affected region and visual improvement, the interval for each treatment and final visual acuity. However, the vision was improved in 45 of 50 cases who had an initial visual acuity of above light perception, but in the two of 32 cases with no light perception. If indicated, fifteen cases were treated with a combination of high dose corticosteroid and optic nerve decompression. In initial treatment of traumatic optic neuropathy, high dose corticosteroid was effecive. Whether or not initial visual acuity was better than light perception was a key risk factor in the outcome.