Traumatic optic neuropathy: to treat or not to treat? Report of two cases.

CASE REPORTS: We present two cases of blunt ocular trauma with clinical findings and complementary tests compatible with traumatic optic neuropathy (TON), and progression to sectorial optic atrophy. DISCUSSION: TON have an essentially clinical diagnosis, and in the last few years has been treated with high doses of intravenous steroids, based on weak evidence of the benefit of the steroids in cases of medular trauma. Nevertheless, subsequent studies have concluded that there is a relatively high proportion of cases in all series with spontaneous visual recovery, and there was no convincing evidence of a benefit of steroids compared to observation only.

Neuropatía óptica traumática: ¿tratar o no tratar? A propósito de dos casos / Traumatic optic neuropathy: To treat or not to treat? Report of two cases

Casos clínicos: Se presentan dos casos de traumatismo ocular contuso con hallazgos clínicos y pruebas complementarias compatibles con neuropatía óptica traumática (NOT), y evolución a atrofia sectorial de la papila. Discusión: La NOT tiene un diagnóstico primordialmente clínico y se ha tratado en los últimos años con altas dosis de corticoesteroides intravenosos, basándose en una evidencia débil de beneficio de los esteroides en traumatismos medulares. Sin embargo, estudios posteriores llevan a concluir que existe en todas las series una proporción relativamente alta de casos con recuperación visual espontánea, y ningún dato convincente de beneficio de los esteroides sobre la observación(AU)

Case reports: We present two cases of blunt ocular trauma with clinical findings and complementary tests compatible with traumatic optic neuropathy (TON), and progression to sectorial optic atrophy. Discussion: TON have an essentially clinical diagnosis, and in the last few years has been treated with high doses of intravenous steroids, based on weak evidence of the benefit of the steroids in cases of medular trauma. Nevertheless, subsequent studies have concluded that there is a relatively high proportion of cases in all series with spontaneous visual recovery, and there was no convincing evidence of a benefit of steroids compared to observation only(AU)