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Abstract：
To analyze the visual outcome in patients with traumatic optic neuropathy (TON) with respect to different treatment modalities, to study the correlation of initial visual loss with the final visual outcome, and to find out the predictor of final visual outcome in patients with indirect TON.
A retrospective analysis of 36 eyes with TON was done. Data on clinical profile, including demographics, mode of trauma, best corrected visual acuity (BCVA), pupillary reflex examination, and anterior and posterior segment examination, was collected. Presence and location of orbital and cranial fractures were identified from computed tomography scan. Visual outcomes following steroid therapy, optic nerve (ON) decompression, and in untreated patients were analyzed. Pre- and post-treatment BCVA were divided into three groups based on logarithm of the minimum angle of resolution (logMAR) as follows: group A: 3, group B: 2.9-1.3, and group C<1.3. BCVA values at follow-up visits were taken as the primary outcome measure. Association between various risk factors and final visual outcome in patients with indirect TON was also analyzed.
Out of 34 patients whose 36 eyes were studied, three (8.8%) patients were females and 31 (91.2%) patients were males. Most common mode of trauma was road traffic accident (RTA; 91.2%), which was followed by fall (8.8%) and assault (2.9%). Pre- and post-treatment BCVA values of 36 eyes were compared, and improvement in BCVA after treatment was found to be statistically significant. Also, 28.6% of patients with presenting BCVA of no light perception showed improvement compared to 94.1% and 100% in groups B and C, respectively. Orbital wall fractures were seen in 80.5% (n = 29) of the patients, with lateral wall fracture being the most common (58.3%) followed by medial wall (33.3%), roof (27.7%), floor (27.7%), and optic strut (5%).
Baseline BCVA had significant association with final vision improvement. Lateral wall fracture was the most common fracture associated with indirect TON. Patients treated with high-dose corticosteroids, irrespective of the time of presentation, had a better visual outcome.
A retrospective analysis of 36 eyes with TON was done. Data on clinical profile, including demographics, mode of trauma, best corrected visual acuity (BCVA), pupillary reflex examination, and anterior and posterior segment examination, was collected. Presence and location of orbital and cranial fractures were identified from computed tomography scan. Visual outcomes following steroid therapy, optic nerve (ON) decompression, and in untreated patients were analyzed. Pre- and post-treatment BCVA were divided into three groups based on logarithm of the minimum angle of resolution (logMAR) as follows: group A: 3, group B: 2.9-1.3, and group C<1.3. BCVA values at follow-up visits were taken as the primary outcome measure. Association between various risk factors and final visual outcome in patients with indirect TON was also analyzed.
Out of 34 patients whose 36 eyes were studied, three (8.8%) patients were females and 31 (91.2%) patients were males. Most common mode of trauma was road traffic accident (RTA; 91.2%), which was followed by fall (8.8%) and assault (2.9%). Pre- and post-treatment BCVA values of 36 eyes were compared, and improvement in BCVA after treatment was found to be statistically significant. Also, 28.6% of patients with presenting BCVA of no light perception showed improvement compared to 94.1% and 100% in groups B and C, respectively. Orbital wall fractures were seen in 80.5% (n = 29) of the patients, with lateral wall fracture being the most common (58.3%) followed by medial wall (33.3%), roof (27.7%), floor (27.7%), and optic strut (5%).
Baseline BCVA had significant association with final vision improvement. Lateral wall fracture was the most common fracture associated with indirect TON. Patients treated with high-dose corticosteroids, irrespective of the time of presentation, had a better visual outcome.
摘要：
■分析不同治疗方式的外伤性视神经病变（TON）患者的视力结果，为了研究初始视力丧失与最终视力结果的相关性，并找出间接TON患者最终视觉结果的预测因子。
■对36只眼TON进行回顾性分析。临床资料,包括人口统计，创伤模式，最佳矫正视力（BCVA），瞳孔反射检查,前段和后段检查，被收集。从计算机断层扫描中确定了眼眶和颅骨骨折的存在和位置。类固醇治疗后的视觉结果，视神经（ON）减压术，并对未经治疗的患者进行了分析。治疗前后BCVA根据最小分辨率角（logMAR）的对数分为三组：A组：3，B组：2.9-1.3，C组<1.3。随访时的BCVA值作为主要结果测量。还分析了间接TON患者的各种危险因素与最终视觉结果之间的关系。
■在研究了36只眼的34例患者中，3例(8.8%)为女性,31例(91.2%)为男性.最常见的创伤模式是道路交通事故（RTA;91.2％），其次是下跌(8.8%)和袭击(2.9%)。比较36眼治疗前后BCVA值,发现治疗后BCVA的改善具有统计学意义。此外，与B组和C组的94.1％和100％相比，28.6％的无光感BCVA患者表现出改善，分别。80.5%(n=29)的患者出现眼眶壁骨折,最常见的是外侧壁骨折（58.3%），其次是内侧壁骨折（33.3%），屋顶(27.7%)，楼层(27.7%),和光学支柱(5%)。
■基线BCVA与最终视力改善有显著关联。侧壁骨折是与间接TON相关的最常见骨折。接受大剂量皮质类固醇治疗的患者，无论演示时间如何，有更好的视觉效果。
■对36只眼TON进行回顾性分析。临床资料,包括人口统计，创伤模式，最佳矫正视力（BCVA），瞳孔反射检查,前段和后段检查，被收集。从计算机断层扫描中确定了眼眶和颅骨骨折的存在和位置。类固醇治疗后的视觉结果，视神经（ON）减压术，并对未经治疗的患者进行了分析。治疗前后BCVA根据最小分辨率角（logMAR）的对数分为三组：A组：3，B组：2.9-1.3，C组<1.3。随访时的BCVA值作为主要结果测量。还分析了间接TON患者的各种危险因素与最终视觉结果之间的关系。
■在研究了36只眼的34例患者中，3例(8.8%)为女性,31例(91.2%)为男性.最常见的创伤模式是道路交通事故（RTA;91.2％），其次是下跌(8.8%)和袭击(2.9%)。比较36眼治疗前后BCVA值,发现治疗后BCVA的改善具有统计学意义。此外，与B组和C组的94.1％和100％相比，28.6％的无光感BCVA患者表现出改善，分别。80.5%(n=29)的患者出现眼眶壁骨折,最常见的是外侧壁骨折（58.3%），其次是内侧壁骨折（33.3%），屋顶(27.7%)，楼层(27.7%),和光学支柱(5%)。
■基线BCVA与最终视力改善有显著关联。侧壁骨折是与间接TON相关的最常见骨折。接受大剂量皮质类固醇治疗的患者，无论演示时间如何，有更好的视觉效果。
