Prognostic factors of trans-ethmosphenoid optic canal decompression for indirect traumatic optic neuropathy

Ying-Jie Ma; Bo Yu; Yun-Hai Tu; Bang-Xun Mao; Xin-Yi Yu; Wen-Can Wu

doi:10.18240/ijo.2018.07.24

Prognostic factors of trans-ethmosphenoid optic canal decompression for indirect traumatic optic neuropathy

Int J Ophthalmol. 2018 Jul 18;11(7):1222-1226. doi: 10.18240/ijo.2018.07.24. eCollection 2018.

Authors

Ying-Jie Ma¹, Bo Yu², Yun-Hai Tu², Bang-Xun Mao¹, Xin-Yi Yu¹, Wen-Can Wu²

Affiliations

¹ Eye Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
² Department of Orbital and Oculoplastic Surgery, Eye Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.

Abstract

Aim: To investigate a possible correlation between visual acuity (VA) prognosis and the presence at baseline of various orbital and ocular signs in patients affected by indirect traumatic optic neuropathy (ITON).

Methods: From July 1^st, 2012 to July 1^st, 2015, 224 adults diagnosed with ITON who underwent endoscopic trans-ethmosphenoid optic canal decompression (ETOCD) were reviewed. Visual outcome before and after treatment were taken into comparison.

Results: Accompanied older in age, longer time to medical treatment and existence of optic canal fracture (OCF) were the independent predictors for poor postoperative VA and lower improvement degree of visual acuity (IDVA), while worse preoperative VA was predictive factor for poor postoperative VA only. Mean value of IDVA in patients with OCF was 0.19±0.30. Mean value of IDVA in patients without OCF was 0.29±0.35. IDVA in cases without OCF was significant higher than those with OCF (t=2.272, P<0.05).

Conclusion: Patients suffered from ITON without OCF before ETOCD have better surgical outcome than those with OCF. Older in age, longer time to medical treatment and existence of OCF are independent factors for poor VA prognosis and lower IDVA. Preoperative VA is independent factor for VA prognosis only.

Keywords: adults; improvement degree of visual acuity; indirect traumatic optic neuropathy; trans-ethmosphenoid optic canal decompression; visual acuity.