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Traumatic optic neuropathy

Bo Yu, Yingjie Ma, Yunhai Tu, Wencan Wu
Purpose. To present the safety and effect of endoscopic transethmosphenoid optic canal decompression (ETOCD) for indirect traumatic optic neuropathy (ITON) patients with no-light-perception (NLP). Methods. A retrospective study performed on 96 patients (96 eyes) with NLP after ITON between June 1, 2010, and June 1, 2015, who underwent ETOCD, was reviewed. Visual outcome before and after treatment was taken into comparison. Results. The overall visual acuity improvement rate after surgery was 46.9%. The improvement rates of visual acuity of patients who received treatment within 3 days of injury, 3-7 days after injury, and later than 7 days were 63...
2016: Journal of Ophthalmology
Yonju Ha, Hua Liu, Shuang Zhu, Panpan Yi, Wei Liu, Jared Nathanson, Rakez Kayed, Bradford Loucas, Jiaren Sun, Laura J Frishman, Massoud Motamedi, Wenbo Zhang
Traumatic optic neuropathy (TON) is an acute injury of the optic nerve secondary to trauma. Loss of retinal ganglion cells (RGCs) is a key pathological process in TON, yet mechanisms responsible for RGC death remain unclear. In a mouse model of TON, real-time noninvasive imaging revealed a dramatic increase in leukocyte rolling and adhesion in veins near the optic nerve (ON) head at 9 hours after ON injury. Although RGC dysfunction and loss were not detected at 24 hours after injury, massive leukocyte infiltration was observed in the superficial retina...
December 10, 2016: American Journal of Pathology
Supanut Apinyawasisuk, Jane W Chan, Anthony C Arnold
A 19-year-old man developed visual loss in the left eye 1 day following a martial arts kick to the head. Vision worsened over a week, when visual loss was noted in the right eye without further trauma. The fundus was initially normal, but visual field testing showed temporal depression right eye with diffuse depression left eye, and traumatic chiasmopathy was suspected. Magnetic resonance imaging (MRI) of the brain demonstrated an enlarged chiasm with intrinsic signal abnormality, but no enhancement. Treatment with intravenous corticosteroids and hyperbaric oxygen therapy did not result in visual improvement...
August 2016: Neuro-ophthalmology
Yang Hu
Injury to central nervous system axons is a common early characteristic of neurodegenerative diseases. Depending on its location and the type of neuron, axon injury often leads to axon degeneration, retrograde neuronal cell death and progressive permanent loss of vital neuronal functions. Although these sequential events are clearly connected, ample evidence indicates that neuronal soma and axon degenerations are active autonomous processes with distinct molecular mechanisms. By exploiting the anatomical and technical advantages of the retinal ganglion cell (RGC)/optic nerve (ON) system, we demonstrated that inhibition of the PERK-eIF2α-CHOP pathway and activation of the X-box binding protein 1 pathway synergistically protect RGC soma and axon, and preserve visual function, in both acute ON traumatic injury and chronic glaucomatous neuropathy...
October 2016: Neural Regeneration Research
Ayşe Dolar Bilge, Hakan Yılmaz, Bülent Yazıcı, Faisal Naqadan
BACKGROUND: The present study is an evaluation of clinical features and management outcomes of patients operated on for intraorbital foreign bodies (FBs). METHODS: Medical records of 24 patients who underwent surgery for intraorbital FBs within a 10-year period were reviewed. RESULTS: Twenty patients (83%) were male and 4 (17%) were female (mean age: 28 years; range: 4-69 years). Ten patients (42%) presented within 48 hours of injury, 7 (29%) within 3 days to 1 month, and 7 (29%) more than 1 month after injury...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Reena Sharma, Sanjay Sharma, Swati Phuljhele, Rohit Saxena
We describe a unique case of orbital gunshot injury with isolated intraorbital pellets lodged symmetrically in the two apices, causing identical clinical presentation, and absence of any associated globe or cerebral injury. He developed bilateral complete third nerve palsy with bilateral traumatic optic neuropathy. The optic nerve strut prevented the pellets from going into the brain on both the sides.
September 2016: Oman Journal of Ophthalmology
Fikri M Abu-Zidan, Korana Balac, Chetana Anand Bhatia
The indications of point-of-care ultrasound (POCUS) in the management of multiple trauma patients have been expanding. Although computed tomography (CT) scan of the orbit remains the gold standard for imaging orbital trauma, ultrasound is a quick, safe, and portable tool that can be performed bedside. Here we report two patients who had severe eye injuries with major visual impairment where surgeon-performed POCUS was very useful. One had a foreign body injury while the other had blunt trauma. POCUS was done using a linear probe under sterile conditions with minimum pressure on the eyes...
October 16, 2016: World Journal of Clinical Cases
Nathan H Waldron, Bryant W Stolp, Michael P Ogilvie, David B Powers, Michael R Shaughnessy
We present the case report of a 49-year-old gentleman with a history of adenoid cystic carcinoma of the left nare status post curative bifrontal craniotomy, left lateral rhinotomy and medial maxillectomy, adjuvant radiotherapy, and orbital exenteration for optic neuropathy, complicated by medial wall dehiscence. His course was also complicated by severe radiation trismus, for which he was scheduled to undergo bilateral mandibular coronoidectomies. Given his limited mouth opening, the surgeon requested a nasal endotracheal tube...
November 2016: Journal of Clinical Anesthesia
Kai B Kang, Scott Jones, Amjad Ahmad, Heather E Moss
We report a case of a 16 year-old healthy male, who experienced loss of vision in the right eye immediately after getting punched by a fist. His visual acuity improved to 20/20 within hours, and the optic nerve head appeared normal. CT scan of the orbits showed fractures of the right inferior orbital wall and lamina papyracea. The morning after the injury, he awoke with right eye vision decline to count fingers. There was pallid optic nerve swelling. MRI scan of the orbits showed right medial rectus enlargement and no optic canal abnormalities...
2016: Neuro-ophthalmology
A Le Guern, C Marks-Delesalle, L Borry, J Chekroun, C Ciocanea, C Gruchala, L Gogneaux, A Lossouarn, J M Mery, L Nielloud, V Vasseur, S Defoort-Dhelemmes
Although underestimated, visual involvement is among the most frequent neurological complications of head trauma. There is no consensus in the management of these patients and visual recovery is uncertain. The goal of our study is to describe the clinical presentation and the clinical course of traumatic optic neuropathy in patients with head or maxillo-facial trauma. The clinical records of 8 patients, treated from November 2007 to March 2012, were reviewed in the department of ophthalmology (visual testing) of the university regional medical center in Lille...
September 2016: Journal Français D'ophtalmologie
S Pokharel, D Sherpa, R Shrestha, K Shakya, R Shrestha, O K Malla, C L Pradhananga, R P Pokhrel, P Shrestha
BACKGROUND: Traumatic optic neuropathy is an acute injury of the optic nerve due to trauma. It is an ocular emergency, requiring early treatment though there is no proven standard treatment protocol for the condition. Various studies have shown improvement in vision after intravenous steroids, but not statistically significant. Studies have revealed even optical decompression surgery is not the ultimate treatment because of no significant improvement of vision. Our study aims to assess visual outcome after high dose (1 gram) of intravenous methylprednisolone in cases with indirect optic neuropathy...
January 2016: Journal of Nepal Health Research Council
Ye Tao, Tao Chen, Bei Liu, Li-Qiang Wang, Guang-Hua Peng, Li-Min Qin, Zhong-Jun Yan, Yi-Fei Huang
Transcorneal electrical stimulation (TES) is a novel therapeutic approach to activate the retina and related downstream structures. TES has multiple advantages over traditional treatments, such as being minimally invasive and readily applicable in a routine manner. Series of animal experiments have shown that TES protects the retinal neuron from traumatic or genetic induced degeneration. These laboratory evidences support its utilization in ophthalmological therapies against various retinal and optical diseases including retinitis pigmentosa (RP), traumatic optic neuropathy, anterior ischemic optic neuropathy (AION), and retinal artery occlusions (RAOs)...
2016: International Journal of Ophthalmology
Ju-Yeun Lee, Kyuyeon Cho, Kyung-Ah Park, Sei Yeul Oh
The aims of this study were 1) To evaluate retinal nerve fiber layer (fRNFL) thickness and ganglion cell layer plus inner plexiform layer (GCIPL) thickness at the fovea in eyes affected with traumatic optic neuropathy (TON) compared with contralateral normal eyes, 2) to further evaluate these thicknesses within 3 weeks following trauma (defined as "early TON"), and 3) to investigate the relationship between these retinal layer thicknesses and visual function in TON eyes. Twenty-nine patients with unilateral TON were included...
2016: PloS One
Wentao Yan, Yingbai Chen, Zhenbin Qian, Dinesh Selva, Daniel Pelaez, Yunhai Tu, Wencan Wu
OBJECTIVE: To correlate the intraoperative endoscopic findings with high-resolution CT (HRCT) for the diagnosis of optic canal fractures (OCF). To compare the visual outcome of patients with different types of OCF and without. DESIGN: A retrospective, comparative case series. PARTICIPANTS: 1275 consecutive patients (1275 eyes) with indirect traumatic optic neuropathy (TON). METHODS: Altogether, 1275 patients who underwent endoscopic transethmoid optic canal decompression (ETOCD) for unilateral indirect TON were reviewed from 1 October 2006 to 30 September 2014...
June 6, 2016: British Journal of Ophthalmology
C H van Herpen, W A C Koekkoek, R S Ramrattan, D H T Tjan
BACKGROUND: Shock can lead to ischemic injury of organs. Ischemic injury of the optic nerve may even cause blindness. CASE DESCRIPTION: A 61-year-old female patient was admitted to ICU with septic shock. When recovering, she was only able to determine the difference between light and dark; before admission her vision was good. Ophthalmologic examination revealed slow pupillary reflexes and pale, atrophic optic discs. The diagnosis of bilateral shock-induced ischemic optic neuropathy was made...
2016: Nederlands Tijdschrift Voor Geneeskunde
Liu Yang, Shaohua Li, Linqing Miao, Haoliang Huang, Feisi Liang, Xiuyin Teng, Lin Xu, Qizhao Wang, Weidong Xiao, William H Ridder, Toby A Ferguson, Dong Feng Chen, Randal J Kaufman, Yang Hu
UNLABELLED: Axon injury is an early event in neurodegenerative diseases that often leads to retrograde neuronal cell death and progressive permanent loss of vital neuronal functions. The connection of these two obviously sequential degenerative events, however, is elusive. Deciphering the upstream signals that trigger the neurodegeneration cascades in both neuronal soma and axon would be a key step toward developing the effective neuroprotectants that are greatly needed in the clinic...
May 25, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Vinoth Kanna Selvaraj, Ramachandran Viswanathan, Vasudevan Devanathan
Visual impairment following head injury may be an enigma especially if the onset of symptoms were to be few days after the actual trauma and the bias arising out of the initial normal ophthalmological examination is not neutralised by unbiased repeated formal clinical evaluation aided with electrophysiology. We report and discuss here a 32-year-old lady with delayed onset of indirect traumatic visual loss with anaemia who failed to improve after blood transfusion but improved immediately following steroid therapy seven days after trauma...
March 2016: Journal of Clinical and Diagnostic Research: JCDR
Neha Goel, Metu Rajput, Amrita Sawhney, Tushar Sardana
Macular infarction is a visually disabling condition caused by a variety of reasons. It has rarely been described in association with blunt ocular trauma. We describe the case of a young healthy male who sustained injury with a bull's leg and presented with severe visual loss owing to macular infarction and traumatic optic neuropathy. This report of an angiographically documented macular infarct secondary to ocular contusion highlights an additional feature in the spectrum of ocular findings following blunt trauma that might lead to a severe and permanent affliction of vision...
January 2016: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
Tingzhong Wang, Shuang Ma, Yongchang Guan, Jinghua Du, Guojun Liu, Xianlin Zhao
Intracranial pressure (ICP) monitoring based on flash visual evoked potentials (F-VEP) is a noninvasive method of monitoring ICP. The early diagnosis of traumatic optic neuropathy (TON) in unconscious patients with traumatic brain injury (TBI) is a challenge. The aim of this study was to evaluate the function of F-VEP ICP monitoring in predicting TON and detecting contusion enlargement (CE) in unconscious TBI patients using a modified approach. A series of F-VEP ICP-monitored unconscious TBI patients were included in the study...
May 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Małgorzata Nita, Andrzej Grzybowski
The reactive oxygen species (ROS) form under normal physiological conditions and may have both beneficial and harmful role. We search the literature and current knowledge in the aspect of ROS participation in the pathogenesis of anterior and posterior eye segment diseases in adults. ROS take part in the pathogenesis of keratoconus, Fuchs endothelial corneal dystrophy, and granular corneal dystrophy type 2, stimulating apoptosis of corneal cells. ROS play a role in the pathogenesis of glaucoma stimulating apoptotic and inflammatory pathways on the level of the trabecular meshwork and promoting retinal ganglion cells apoptosis and glial dysfunction in the posterior eye segment...
2016: Oxidative Medicine and Cellular Longevity
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