Interventions for Indirect Traumatic Optic Neuropathy

Wladis, Edward J.; Aakalu, Vinay K.; Sobel, Rachel K.; McCulley, Timothy J.; Foster, Jill A.; Tao, Jeremiah; Freitag, Suzanne K.; Yen, Michael T.

doi:10.1016/j.ophtha.2020.10.038

Cited by 38 publications

(20 citation statements)

References 34 publications

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“…El tratamiento del iTON es controvertido y se han propuesto múltiples enfoques. Además de la descompresión del canal óptico como terapia quirúrgica principal, algunos estudios reportaron los beneficios de la eritropoyetina intravenosa, o también el uso de corticoides (7) . La levodopa-carbidopa se aplicó a pacientes con iTON (8) .…”

Section: Discussionunclassified

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Factor de crecimiento nervioso en neuropatía óptica traumática

Quispe¹,

Echavigurin²,

Gonzales³

2023

Horizmed

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La neuropatía óptica traumática (TON) es una entidad asociada al trauma facial y craneal, y constituye una causa importante para el desarrollo de la ceguera; es una complicación grave del trauma craneofacial que daña directa (dTON) o indirectamente (iTON) el nervio óptico (ON), cuya incidencia global de TON es de 0,7 a 2,5 %. El objetivo del presente estudio es presentar el caso de un paciente que padecía de TON y a la vez de una afección bilateral asimétrica, y que fue tratado con el factor de crecimiento nervioso mNGF. Este medicamento fue el primero que se descubrió y demostró eficacia en mantener la supervivencia de las neuronas centrales y periféricas y facilitar su crecimiento, diferenciación y regeneración. Se trata de un paciente de 13 años, sexo masculino, quien acude a la emergencia del Instituto Nacional de Ciencias Neurológicas y, posteriormente, su seguimiento clínico es por consultorio de Neuroftalmología, con un cuadro de amaurosis traumática, producto de un traumatismo encéfalo craneano con hematoma epidural, que recibió dos ciclos de tratamiento con factor de crecimiento nervioso. Luego del primer ciclo de tratamiento, se evidenció hiporreactividad de ambos ojos; al finalizar el segundo ciclo de tratamiento, se observó un aumento considerable de la agudeza visual. El mNGF está aprobado y comercializado en China desde el año 2015 y es un producto que ha demostrado su eficacia y seguridad en varios ensayos clínicos. Por ello, el presente estudio pretende convertir al factor de crecimiento nervioso como el tratamiento prometedor de iTON; en ese sentido, se necesita de amplias investigaciones clínicas en este caso en particular.

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Section: Discussionunclassified

“…La levodopa-carbidopa se aplicó a pacientes con iTON (8) . Sin embargo, no está claro el tratamiento adecuado para un iTON (7) .…”

Section: Discussionunclassified

Factor de crecimiento nervioso en neuropatía óptica traumática

Quispe¹,

Echavigurin²,

Gonzales³

2023

Horizmed

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“…123 In 2020, the American Academy of Ophthalmology reported that the benefits of SCS for TON remains uncertain, noting that the evidence is at best weak and acknowledging the unfavorable side-effect profile. 124 A 2010 RCT showed that SCS may increase mortality in patients with traumatic brain injury, which often coexists with TON. 125 More robust data are needed to define the role of SCS for TON.…”

Section: Optic Neuropathymentioning

confidence: 99%

Systemic Steroids for Otolaryngology–Head and Neck Surgery Disorders: An Evidence‐Based Primer for Clinicians

McCoul

Megwalu

Joe

et al. 2022

Otolaryngol.--head neck surg.

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Objective To offer pragmatic, evidence-informed guidance on the use of systemic corticosteroids (SCS) for common otolaryngologic disorders. Data Sources PubMed, Cochrane Library, and American Academy of Otolaryngology–Head and Neck Surgery Foundation clinical practice guidelines. Review Methods A comprehensive search of published literature through November 2021 was conducted on the efficacy of SCS, alone or in combination with other treatments, for managing disorders in otolaryngology and the subdisciplines. Clinical practice guidelines, systematic reviews, and randomized controlled trials, when available, were preferentially retrieved. Interventions and outcomes of SCS use were compiled to generate summary tables and narrative synthesis of findings. Conclusions Evidence on the effectiveness of SCS varies widely across otolaryngology disorders. High-level evidence supports SCS use for Bell’s palsy, sinonasal polyposis, and lower airway disease. Conversely, evidence is weak or absent for upper respiratory tract infection, eustachian tube dysfunction, benign paroxysmal positional vertigo, adenotonsillar hypertrophy, or nonallergic rhinitis. Evidence is indeterminate for acute laryngitis, acute pharyngitis, acute sinusitis, angioedema, chronic rhinosinusitis without polyps, Ménière’s disease, postviral olfactory loss, postoperative nerve paresis/paralysis, facial pain, and sudden sensorineural hearing loss. Implications for Practice Clinicians should bring an evidence-informed lens to SCS prescribing to best counsel patients regarding the risks, anticipated benefits, and limited data on long-term effects. Alternate routes of corticosteroid administration—such as sprays, drops, inhalers, and intralesional injections—may be preferable for many disorders, particularly those that are self-limited or require a prolonged duration of therapy. Prudent use of SCS reduces the risk of medication-related adverse effects. Clinicians who are conversant with high-level evidence can achieve optimal outcomes and stewardship when prescribing SCS.

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“…There is currently no approved standardised treatment therapy for TON [ 87 ], but observation of injury progression is recommended. As well as observing and monitoring, current treatment options at the moment consist of a course of high-dose steroids, surgical decompression (relieves pressure around optic nerve), and combination of steroids and surgery [ 47 ].…”

Section: Treatment Of Tonmentioning

confidence: 99%

Traumatic brain injury and sight loss in military and veteran populations– a review

Hussain¹,

Raza²,

Cash³

et al. 2021

Military Med Res

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War and combat exposure pose great risks to the vision system. More recently, vision related deficiencies and impairments have become common with the increased use of powerful explosive devices and the subsequent rise in incidence of traumatic brain injury (TBI). Studies have looked at the effects of injury severity, aetiology of injury and the stage at which visual problems become apparent. There was little discrepancy found between the frequencies or types of visual dysfunctions across blast and non-blast related groups, however complete sight loss appeared to occur only in those who had a blast-related injury. Generally, the more severe the injury, the greater the likelihood of specific visual disturbances occurring, and a study found total sight loss to only occur in cases with greater severity. Diagnosis of mild TBI (mTBI) is challenging. Being able to identify a potential TBI via visual symptoms may offer a new avenue for diagnosis.

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Interventions for Indirect Traumatic Optic Neuropathy

Cited by 38 publications

References 34 publications

Factor de crecimiento nervioso en neuropatía óptica traumática

Factor de crecimiento nervioso en neuropatía óptica traumática

Systemic Steroids for Otolaryngology–Head and Neck Surgery Disorders: An Evidence‐Based Primer for Clinicians

Traumatic brain injury and sight loss in military and veteran populations– a review

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