Outcome of the surgical decompression for traumatic optic neuropathy: a systematic review and meta-analysis

Martínez-Pérez, Rafael; Albonette-Felicio, Thiago; Hardesty, Douglas A.; Carrau, Ricardo L.; Prevedello, Daniel M.

doi:10.1007/s10143-020-01260-z

Cited by 16 publications

(10 citation statements)

References 35 publications

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“…Indeed, 68.8% of the steroid-treated group had significant improvement in visual acuity compared with 53.3% of the placebo group (p ¼ 0.38). A more recent meta-analysis of treatment options for TON 61 concluded that the literature suggests that patients with TON who undergo early optic canal decompression have better visual outcomes compared with those who are observed or treated with steroids; however, the authors pointed out that the lack of a randomized controlled trial-and the inherent surgical selection and publication bias of the available reports-limits a direct comparison between surgical decompression and conservative management.…”

Section: Corticosteroidsmentioning

confidence: 99%

Traumatic Optic Neuropathy

Miller

2021

J Neurol Surg B Skull Base

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A host of different types of direct and indirect, primary and secondary injuries can affect different portions of the optic nerve(s). Thus, in the setting of penetrating as well as nonpenetrating head or facial trauma, a high index of suspicion should be maintained for the possibility of the presence of traumatic optic neuropathy (TON). TON is a clinical diagnosis, with imaging frequently adding clarification to the full nature/extent of the lesion(s) in question. Each pattern of injury carries its own unique prognosis and theoretical best treatment; however, the optimum management of patients with TON remains unclear. Indeed, further research is desperately needed to better understand TON. Observation, steroids, surgical measures, or a combination of these are current cornerstones of management, but statistically significant evidence supporting any particular approach for TON is absent in the literature. Nevertheless, it is likely that novel management strategies will emerge as more is understood about the converging pathways of various secondary and tertiary mechanisms of cell injury and death at play in TON. In the meantime, given our current deficiencies in knowledge regarding how to best manage TON, “primum non nocere” (first do no harm) is of utmost importance.

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Section: Corticosteroidsmentioning

confidence: 99%

Traumatic Optic Neuropathy

Miller

2021

J Neurol Surg B Skull Base

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“…The most common complication after OCD has been CSF leakage in 1.7% to 45%. 25 It is important that readers interpret the visual outcome of this study with caution. Actually, the frequency of visual recovery after OCD is 30-55% that is close to the rate of spontaneous recovery, corticosteroids and erythropoietin, in published controlled clinical trials.…”

Section: Is Optic Canal Decompression Still a Viable Option In Traumatic Optic Neuropathy?mentioning

confidence: 99%

Optic canal decompression in traumatic optic neuropathy

Pakdel¹

2020

IJCEO

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“…Traumatic optic neuropathy, while relatively rare, typically occurs following head injuries. It is severe and most often irreversible, similar to the optic nerve crush procedure utilized for laboratory studies (14). Besides head trauma, the ON can sustain acute or progressive physical damage as a result of tumors, compression, and infections (11,13).…”

Section: Common Optic Neuropathies With Injury To Retinal Ganglion Cell Axonsmentioning

confidence: 99%

The basic science of optic nerve regeneration

Fague¹,

Liu²,

Marsh-Armstrong³

2021

Ann Transl Med

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Diverse insults to the optic nerve result in partial to total vision loss as the axons of retinal ganglion cells are destroyed. In glaucoma, axons are injured at the optic nerve head; in other optic neuropathies, axons can be damaged along the entire visual pathway. In all cases, as mammals cannot regenerate injured central nervous system cells, once the axons are lost, vision loss is irreversible. However, much has been learned about how retinal ganglion cells respond to axon injuries, and many of these crucial discoveries offer hope for future regenerative therapies. Here we review the current understanding regarding the temporal progression of axonal degeneration. We summarize known survival and regenerative mechanisms in mammals, including specific signaling pathways, key transcription factors, and reprogramming genes. We cover mechanisms intrinsic to retinal ganglion cells as well as their interactions with myeloid and glial cell populations in the retina and optic nerve that affect survival and regeneration.Finally, we highlight some non-mammalian species that are able to regenerate their retinal ganglion cell axons after injury, as understanding these successful regenerative responses may be essential to the rational design of future clinical interventions to regrow the optic nerve. In the end, a combination of many different molecular and cellular interventions will likely be the only way to achieve functional recovery of vision and restore quality of life to millions of patients around the world.

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Outcome of the surgical decompression for traumatic optic neuropathy: a systematic review and meta-analysis

Cited by 16 publications

References 35 publications

Traumatic Optic Neuropathy

Traumatic Optic Neuropathy

Optic canal decompression in traumatic optic neuropathy

The basic science of optic nerve regeneration

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