Affection of Surgical Decompressive Scale of Optic Canal to Traumatic Optic Neuropathy.

Traumatic optic neuropathy (TON) is damage to the optic nerve that is caused by external violence to the optic nerve during cranial and facial trauma. This kind of injury may result in impaired vision, has a high risk of blindness, and significantly impairs the neurological function of the patient. The treatment of TON is controversial, and many different approaches have been suggested. No one is considered best because the traumatic mechanism is not clear.

Methods

In this retrospective study, the clinical features of 37 patients diagnosed with TON without light perception who were treated at the Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine were investigated. A comparison was made between the patient's visual results before and after therapy. In addition, using a multifactorial linear regression model, the independent risk variables for the degree of improvement in visual acuity (IDVA) following surgery were determined.

Results

After the operation, 17 people's visual acuity (VA) was lightless, 20 people's visual acuity was improved, and 13 people's visual acuity reached the standard of decerebrate. The efficiency of total optic nerve decompression was 54.1%, and the unblinded rate was 35.1%. Multiple linear regression analysis revealed that fractures of the optic canal and orbit were independent predictors of postoperative VA and IDVA.

Conclusions

Total optic canal decompression may efficiently and safely enhance the vision of patients who have TON. Patients with TON who do not have fractures of the optic canal and orbit prior to decompression had a more favorable surgical prognosis.