Abstract :

Objective: To determine if optic nerve decompression has any efficacy in patients with traumatic optic nerve (TON) damage specifically those patients whose optic nerves have been severely damaged and as a result, they suffer no light perception (NLP).

Material & Methods: A retrospective study for group of 54 patients was observed for a period of between 3 to 12 months from 2020 to January 2021.

Results: 35 patients still had no light perception at end of the study. By the time others were discharged some had gained a level or two of visual acuity but no cases of perfect vision restored were reported.

Conclusion: The methods were relatively useful in reducing discomfort in patients such as significant reduction in swelling but they were not in any way completely responsible for the total recovery of the patients.

---

Keywords :

Optic Nerve, Optic Nerve Decompression, Traumatic Optic Neuropathy, Vision Loss.

---

References :

1. Chandwick, J & Mann WN The Medical works of Hippocrates. Oxford: England, Backwell 1950
2. Levin L Traumatic Optic Neuropathy; Roy and Fraufelder’s Current Ocular Therapy 6th edition Eds: Roy FH. Fraunfelders FS. Philadelphia 2007; 5(2):73-78
3. Nishi T, Ueda T et al. Traumatic optic neuropathy caused by blunt injury to the inferior orbital rim. J Neurophthalmom, 2006; 26:44-46
4. Van S GP, Biousse V, Lynn MJ et al Neuroophthalmic manifestation of the head trauma. J Neuroophthamol, 2000; 21:112-117
5. Sofferman B. The recovery potential of the optic nerve, Laryngoscope, 1995; 105:1-38
6. Guyer RG, Miller RN MD, Long MD, PHD, et al.Visual function following optical Decompression via Craniotum, Balitimore 1985; 7:112-116
7. Levin LA, Beck RW, Joseph MP The treatment of traumatic optic neuropathy: the international Optic Nerve Trauma Study. Ophthalmology, 1999; 106:1268-1277
8. Steinsapir KD, Goldberg RA Traumatic optic neuropathy; a critical update. Comp Ophthalmol Update, 2005; 6:11-612
9. Steinsapir KD, Goldberg RA Traumatic optic neuropathy Surv Ophthalmol, 1994; 38:487-518
10. Lessel L Traumatic optic neuropathy and visual system injury In Shingleton BJ, Hersh PS, Kenyon KR, Editors Eye trauma. St Louis: Mosby Year Book; 2010 June; 23:371-379
11. Tsai HH, Jengb SF, Linb TS, et al. Predictive value of computed tomography in visual outcome in indirect traumatic optic neuropathy complicated with periorbital facil bone structure. Clin. Neurol. Neurosurg. 2005 april;107(3):200-206
12. Lee AG. Imaging for neuroophthalmic manifestations of the head trauma. J Neuroophthalmol, 2004;138:852-862
13. Kountakis SE, Maillard AAJ, Urso R, et al. Endoscopic approach to traumatic visual loss. Otolaryngol. Head Neck Surg. 1997 June, 116(6): 652-655
14. Rajiniganth MG, Gupta AK, Gupta A, et al. Traumatic optic neuropathy: visual outcome following combined therapy protocol. Arch Otolaryngol Head Neck Surg. 2003 Nov, 129(11):1203-1206
15. Wohlrab TM, Maas S, de Carpentier JP. Surgical decompression in traumatic optic neuropathy. Acta Ophthalmol Scand 2002 Jun, 80(3):287-293
16. Gupta AK, Gupta AK, Gupta A, et al. Traumatic optic neuropathy in pediatric population: early intervention or delayed intervention? Int J Pediatri Otorhinolaryngol. 2007 april, 71(4):559-562
17. Lipkin AF, Woodson GE, Miller RH .Visual loss due to Orbital Fracture. Arch Otolaryngol Head Surg, 1983 Jun, 91(3):276-279
18. Spoor TC, Hartel WC, Lensik DB, et al. Treatment of Traumatic Optic Nerve Neuropathy with Corticosteroid Am J Ophthamol, 1990; 110:665-9.
19. Luxenberg W, Stammerger H, Jebels JA et al. Endoscopic optic nerve decompression: the Graz experience. Laryngoscope, 1998; 108:873-882
20. Lubben B, Stoll W, Grenzebauch U. Optic nerve decompression in the comatose and conscious patients after trauma. Laryngoscope, 2001; 111:320-328
21. Wu N, Yin ZQ, Wang Y. Traumatic neuropathy therapy: an update of clinical and Experimental studies 2008; 36 :883-889
22. Thakar A, Mahaptra AK, Tendons, DA Delayed Optic Decompression for Indirect Optic Nerve Injury, The Laryngoscope, 2003; 113:112-119
23. Ohlsson M. Mattsson P. Svensson M. A temporal study of axonal degenerational glial scar formation following a standardized crush injury of the optic nerve in adult rat Restore Neural Neuroscopy, 2004; 22:1-10