VISUAL OUTCOME OF TRAUMATIC OPTIC NEUROPATHYAFTER STEROID TREATMENT IN KARIADI HOSPITAL
Article Sidebar
-
Traumatic Optic Neuropathy, Steroids, Visual Outcome
Abstract
Introduction: The occurrence of Traumatic Optic Neuropathy (TON) often occurs in the form of head injuries resulting from traffic accidents. TON is an important cause of impaired visual function which may be improved with steroid therapy.
Objective: To determine the visual outcome in patients with TON treated with steroids in Kariadi Hospital, Semarang
Methods: This research was a retrospective study. Thirty patients (20 males and 10 females) with TON in ophthalmology clinic, Kariadi Hospital Semarang between Januari 2019 and December 2020. Visual acuity, contrast sensitivity and color blindness test were included data from medical record. Steroid therapy were divided into 3 groups. Intraveous steroid injection alone, intravenous steroid followed with oral steroid, and oral steroid alone. The Wilcoxon and paired-t test as comparison test of pre-post therapy in one group and friedman test as comparison test in 3 groups.
Results: There were 5 cases that received intravenous steroid, 18 cases received intravenous steroid with oral steroid, and 7 cases received oral steroid. There were difference visual acuity in intravenous steroid with oral steroid (p = 0.001), visual acuity in oral steroid (p = 0.017), and color blindness test in intravenous steroid with oral steroid in pre-post therapy groups (p = 0.036). There were no difference in visual acuity, color blindness test, and contrast sensitivity between pre-post therapy groups when compared between 3 groups (p= 0.692, p =0.368, p=0.273).
Conclusion: Patients with TON had better visual outcome after treated with intravenous steroid followed with oral steroid.
Full text article
References
Levin, L.A., et al., The treatment of traumatic optic neuropathy: the International Optic Nerve Trauma Study. Ophthalmology, 2010. 106(7): p. 1268-77.
AI-Qurainy IA, Dutton GN, Stassen LF, Moos KF, EI-Attar A. The characteristics of midfacial fractures and the association with ocular injury: a prospective study. British journal of oral and maxillofacial surgery. 2010; 29(5):291-301.
Nau HE, Gerhard L, Foerster M, Nahser HC, Reinhardt V, Joka T. Optic nerve trauma: clinical, electrophysiological and histological remarks. Acta neurochirurgica. 2011; 89(1):16-27.
Lee V, Ford RL, Xing W, Bunce C, Foot B. Surveillance of traumatic optic neuropathy in the UK. Eye. 2010; 24(2):240-50.
Yu-Wai-Man P, Griffiths PG. Steroids for traumatic optic neuropathy. The Cochrane Library. 2013.
Atkins EJ, Newman NJ, Biousse V. Post-traumatic visual loss. Rev Neurol Dis 2008;5:73–81.
Yu-Wai-Man P, Griffiths PG. Steroids for traumatic optic neuropathy. Cochrane Database Syst Rev 2007, CD006032.
Young, W., NASCIS. National Acute Spinal Cord Injury Study. J Neurotrauma, 2015. 7(3): p. 113-4.
Edwards, P., et al., Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months. Lancet, 2005. 365(9475): p. 1957-9.
Levin LA, Joseph MP, Rizzo JF 3rd, Lessell S. Optic canal decompression in indirect optic nerve trauma. Ophthalmology 2013:101:566-9
Nishida S, Otani N, Inaka Y, Morinaga Y, Kimura S, Tomura S, et al. Usefulness of extradural optic canal unroofing and decompression of the optic nerve for improvement of visual acuity in traumatic optic neuropathy. No Shinkei Geka 2014;42:1035-8.
Steinsapir KD, Goldberg RA. Traumatic optic neuropathy: a critical update. Compr Ophthalmol Update. 2015; 6(1):11-21.
Authors
Copyright (c) 2024 Isnia Rahmi Roosdhantia, Riski Prihatningtias
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.