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Traumatic optic neuropathy

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
Shangfeng Zhao, Zhaoke Zheng, Haocheng Liu, Yong Li, Jun Kang, Hao Dong, Si Sun, Jialiang Zhang, Tianming Zhang, Jidi Fu
OBJECTIVE: To investigate the relevant factors affecting the prognosis of traumatic optic neuropathy (TON). METHODS: A total of 685 cases (719 eyes) of TON from June 2007 to June 2012 were analyzed retrospectively. A total of 9 independent variables (X) including sex, side of TON, duration of coma, vision after trauma, fracture of optic nerve canal, fracture of big ridge of sphenoid bone, hematoma in sphenoid sinus and surgical treatment, and the dependent variable (Y) of visual prognosis were analyzed using the unconditioned Logistic regression analysis to find the risk factors for the visual prognosis of TON...
October 20, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
I-Li Lai, Han-Tsung Liao, Chien-Tzung Chen
BACKGROUND: Although recent evidence suggests a controversy effect of steroids in the management of indirect traumatic optic neuropathy (TON), steroid pulse therapy remains one of the reasonable treatments for patients with indirect TON. It is thought that microcirculatory spasms, edema, and nerve cell necrosis can be prevented or reduced by large doses of steroids. The aim of this study is to analyze the predisposing factors for the recovery of patients with indirect TON who were treated with steroid pulse therapy...
March 2016: Annals of Plastic Surgery
Sandeep S Dhaliwal, Leigh J Sowerby, Brian W Rotenberg
BACKGROUND: Traumatic optic neuropathy (TON) represents a rare but devastating complication of closed head injuries. No accepted guidelines are available for medical and surgical management algorithms. A systematic review of the literature was performed to determine the optimal timing and candidacy for endoscopic surgical intervention. METHODS: A systematic review of multiple databases was performed including Medline-Ovid, EMBASE, and PubMed. Data was extracted and patients stratified based on surgical delay from trauma (≤3 days, >3 days, ≤7 days, or >7 days) as well as preoperative and postoperative vision testing (no light perception [NLP]; light perception [LP]; hand motion [HM]; or finger counting [FC] or better)...
June 2016: International Forum of Allergy & Rhinology
Michael Sosin, Carla De La Cruz, Gerhard S Mundinger, Sean Y Saadat, Arthur J Nam, Paul N Manson, Michael R Christy, Branko Bojovic, Eduardo D Rodriguez
BACKGROUND: Traumatic optic neuropathy is characterized by sudden loss of vision following facial trauma leading to variable visual deficits. The purpose of this study was to evaluate recent institutional trends in the treatment of traumatic optic neuropathy, evaluate the outcomes of different treatment strategies, and identify factors associated with improved vision. METHODS: Institutional review board approval was obtained to retrospectively review patients diagnosed with traumatic optic neuropathy at a high-volume trauma center from 2004 to 2012...
January 2016: Plastic and Reconstructive Surgery
Jianglong Yu, Xinping Luan, Shiying Lan, Baofeng Yan, Aba Maier
Inhibition of RhoA/Rock could promote axon growth and alleviate optic nerve injury. However, the role of RhoA/Rock in the traumatic retinal nerve in vivo was not completely clear. In this study, we established a rabbit model of traumatic retinal nerve injury, and primary retinal ganglion cells (RGCs) were isolated and cultured under hypoxia-hypoglycemia condition that was mock to the microenvironment in the injured retinas in vivo. The Rock inhibitor fasudil was used to treat primary RGCs and ear vein injected into the model rabbits in vivo...
January 2016: Journal of Molecular Neuroscience: MN
Sanford E Emery, Scott D Daffner, John C France, Matthew Ellison, Brian W Grose, Gerald R Hobbs, Nina B Clovis
BACKGROUND: Ischemic optic neuropathy resulting in visual loss is a rare but devastating complication of spine surgery. Elevated intraocular pressure (IOP) results in decreased perfusion and possibly ischemic optic neuropathy. We performed a randomized, prospective trial to evaluate the effect of head positioning on IOP during lumbar spine fusion. METHODS: The study included fifty-two patients treated at one institution. Inclusion criteria were a lumbar spine fusion and an age of eighteen to eighty years...
November 18, 2015: Journal of Bone and Joint Surgery. American Volume
A Zahavi, J Luckman, I Yassur, S Michowiz, N Goldenberg-Cohen
PURPOSE: Falls from heights are the most common traumatic event associated with emergency department visits in children. This study investigated the incidence and clinical course of cranial neuropathies caused by falls from heights in children. METHODS: The computerized records of a tertiary pediatric medical center were searched for all patients admitted to the emergency department in 2004-2014 with a head injury caused by falling from a height. Those with cranial neuropathies involving optic and eye-motility disturbances were identified, and their clinical, imaging, and outcome data were evaluated...
April 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
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