Blunt Facial Trauma Causing Isolated Optic Nerve Hematoma

Traumatic optic neuropathy is an uncommon, yet serious, result of facial trauma. The authors present a novel case of a 59-year-old gentleman who presented with an isolated blunt traumatic left optic nerve hematoma causing vision loss. There were no other injuries or fractures to report. This case highlights the importance of early recognition of this rare injury and reviews the current literature and management of traumatic optic neuropathy.

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An adherent drug depot for retinal ganglion cell protection and regeneration in rat traumatic optic neuropathy models

RSC Advances ◽

10.1039/d0ra10362d ◽

2021 ◽

Vol 11 (37) ◽

pp. 22761-22772

Author(s):

Lingli Li ◽

Fen Deng ◽

Haijun Qiu ◽

Yao Li ◽

Zan Gong ◽

...

Keyword(s):

Optic Nerve ◽

Ganglion Cell ◽

Retinal Ganglion Cell ◽

Optic Neuropathy ◽

Vision Loss ◽

Penetrating Trauma ◽

Retinal Ganglion ◽

Cell Protection ◽

Traumatic Optic Neuropathy

Traumatic optic neuropathy (TON) describes an injury to the optic nerve following either blunt or penetrating trauma, and remains an important cause of vision loss.

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Treatment of traumatic optic neuropathy: our experience of endoscopic optic nerve decompression

The Journal of Laryngology & Otology ◽

10.1017/s0022215108002296 ◽

2008 ◽

Vol 122 (12) ◽

pp. 1325-1329 ◽

Cited By ~ 30

Author(s):

H Li ◽

B Zhou ◽

J Shi ◽

L Cheng ◽

W Wen ◽

...

Keyword(s):

Optic Nerve ◽

Optic Neuropathy ◽

Visual Loss ◽

Vision Loss ◽

Surgical Decompression ◽

Traumatic Optic Neuropathy ◽

Improvement Rate ◽

Efficient Treatment ◽

Nerve Decompression ◽

Optic Nerve Decompression

AbstractObjective:Traumatic optic neuropathy can be treated by various methods including steroids and surgical decompression. Endoscopic optic nerve decompression has been suggested to be effective in treating this condition. The aim of this study was to assess the outcome of treating traumatic optic neuropathy with steroids and endoscopic surgical decompression.Methods:Two hundred and thirty-seven patients with traumatic optic neuropathy were treated with steroids; 176 also consented to endoscopic optic nerve decompression.Results:The total vision improvement rate was 55 per cent in the 176 patients treated with both steroids and endoscopic optic nerve decompression, compared with 51 per cent in the 61 patients treated with steroids alone; this difference was not statistically significant (p > 0.05). Treatment with steroids plus endoscopic optic nerve decompression resulted in a significantly greater vision improvement in patients with gradual vision loss, compared with those with immediate blindness (68 vs 42 per cent, respectively). Early surgery (within one week) was an important prognostic factor for vision recovery, compared with more delayed surgical treatment (associated vision improvement rates were 60 and 31 per cent, respectively).Conclusions:Endoscopic optic nerve decompression is a minimally invasive, safe and efficient treatment for traumatic optic neuropathy. Used in combination with steroids, it provides effective rescue for some patients suffering visual loss. It should be undertaken as soon as possible.

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Hemorrhage in Onodi Cell Leading to Traumatic Optic Neuropathy

Craniomaxillofacial Trauma & Reconstruction ◽

10.1177/1943387520922021 ◽

2020 ◽

pp. 194338752092202

Author(s):

Aditi Mehta ◽

Ramya Rathod ◽

Chirag Ahuja ◽

Manpreet Singh ◽

Ramandeep S. Virk

Keyword(s):

Computed Tomography ◽

Optic Neuropathy ◽

Vision Loss ◽

Young Male ◽

Facial Trauma ◽

Traumatic Optic Neuropathy ◽

Computed Tomography Imaging ◽

Tomography Imaging ◽

Onodi Cell

Traumatic optic neuropathy (TON) is an important cause of vision loss in the setting of cranial and/or facial trauma. Both direct and indirect variants exist, with the latter being more common. We describe the case of a young male presenting with loss of vision following trauma with an intact globe, an intraorbital foreign body, and Onodi cell hemorrhage. The challenges in diagnoses of type of TON, exact pathology, and management are discussed. We also highlight the role of thin section digital computed tomography imaging which is paramount for timely detection of subtle injuries and their management.

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Endoscopic optic nerve decompression for traumatic optic neuropathy

Operative Techniques in Otolaryngology-Head and Neck Surgery ◽

10.1016/s1043-1810(96)80050-9 ◽

1996 ◽

Vol 7 (3) ◽

pp. 293-296 ◽

Cited By ~ 3

Author(s):

Erica R. Thaler ◽

Donald C. Lanza ◽

David W. Kennedy

Keyword(s):

Optic Nerve ◽

Optic Neuropathy ◽

Traumatic Optic Neuropathy ◽

Nerve Decompression ◽

Optic Nerve Decompression

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RGC and Vision Loss From Traumatic Optic Neuropathy Induced by Repetitive Closed Head Trauma Is Dependent on Timing and Force of Impact

Translational Vision Science & Technology ◽

10.1167/tvst.10.1.8 ◽

2021 ◽

Vol 10 (1) ◽

pp. 8

Author(s):

Reas S. Khan ◽

Ahmara G. Ross ◽

Puya Aravand ◽

Kimberly Dine ◽

Evan B. Selzer ◽

...

Keyword(s):

Head Trauma ◽

Optic Neuropathy ◽

Vision Loss ◽

Traumatic Optic Neuropathy ◽

Closed Head ◽

Closed Head Trauma

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Exosome-Mediated Delivery of the Neuroprotective Peptide PACAP38 Promotes Retinal Ganglion Cell Survival and Axon Regeneration in Rats With Traumatic Optic Neuropathy

Frontiers in Cell and Developmental Biology ◽

10.3389/fcell.2021.659783 ◽

2021 ◽

Vol 9 ◽

Author(s):

Tian Wang ◽

Yiming Li ◽

Miao Guo ◽

Xue Dong ◽

Mengyu Liao ◽

...

Keyword(s):

Optic Nerve ◽

Ganglion Cell ◽

Retinal Ganglion Cell ◽

Optic Neuropathy ◽

Axon Regeneration ◽

Retinal Ganglion ◽

Traumatic Optic Neuropathy ◽

Fiber Layer

Traumatic optic neuropathy (TON) refers to optic nerve damage caused by trauma, leading to partial or complete loss of vision. The primary treatment options, such as hormonal therapy and surgery, have limited efficacy. Pituitary adenylate cyclase-activating polypeptide 38 (PACAP38), a functional endogenous neuroprotective peptide, has emerged as a promising therapeutic agent. In this study, we used rat retinal ganglion cell (RGC) exosomes as nanosized vesicles for the delivery of PACAP38 loaded via the exosomal anchor peptide CP05 (EXOPACAP38). EXOPACAP38 showed greater uptake efficiency in vitro and in vivo than PACAP38. The results showed that EXOPACAP38 significantly enhanced the RGC survival rate and retinal nerve fiber layer thickness in a rat TON model. Moreover, EXOPACAP38 significantly promoted axon regeneration and optic nerve function after injury. These findings indicate that EXOPACAP38 can be used as a treatment option and may have therapeutic implications for patients with TON.

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Outcomes of Steroid Therapy in Combination with Endoscopic Optic Nerve Decompression Surgery for Direct Traumatic Optic Neuropathy: A Case-Series

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.07.12657 ◽

2021 ◽

Vol 104 (7) ◽

pp. 1166-1171

Keyword(s):

Visual Acuity ◽

Optic Nerve ◽

Optic Neuropathy ◽

Poor Prognosis ◽

Combined Treatment ◽

Treatment Protocol ◽

Case Series ◽

Light Perception ◽

Traumatic Optic Neuropathy ◽

Nerve Decompression

Background: Direct traumatic optic neuropathy (TON) carries a poor prognosis. However, the outcome of this injury is diverse and is related to time to treatment and treatment protocol. Objective: To evaluate the outcomes of the combined treatment protocol in patients with direct TON. Materials and Methods: The authors retrospectively reviewed the medical records of patients between January 2015 and August 2019. Main outcome was visual acuity (VA) improvement after the treatment. Results: Thirteen patients (15 eyes) were included. The mean age was 38.61 years with a range of 13 to 65 years. Initial VA varied from no light perception (NPL) in seven eyes of six patients, light perception (PL) in one eye, counting fingers in two eyes, 20/200 in three eyes, and 20/60 in two eyes. Average timing to treatment was 2.8 days (range 0 to 7 days). There were no side effects of high-dose corticosteroids treatment in all patients. During a follow-up period of three months, six of 13 patients (46.1%) had VA improvement. Conclusion: Despite poor prognosis of direct TON, the combined treatment protocol provides a favorable successful rate with most patients on having stable vision, and some having visual improvement from reducing intracanalicular pressure of the optic nerve. Keywords: Endoscopic optic nerve decompression; Traumatic optic neuropathy; Visual acuity; Case series

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Compressive Optic Neuropathy

Neuro-Ophthalmology ◽

10.1093/med/9780195390841.003.0004 ◽

2011 ◽

pp. 21-24

Author(s):

Matthew J. Thurtell ◽

Robert L. Tomsak ◽

Robert B. Daroff

Keyword(s):

Optic Nerve ◽

Optic Neuropathy ◽

Vision Loss ◽

Clinical Signs ◽

Monocular Vision ◽

Compressive Optic Neuropathy ◽

Imaging Characteristics ◽

Optic Nerve Sheath Meningioma ◽

Common Causes ◽

Optic Nerve Compression

Optic nerve compression results in progressive, and often painless, monocular vision loss. In this chapter, we review the clinical signs and common causes of compressive optic neuropathy. We discuss in more detail the imaging characteristics and management of optic nerve sheath meningioma.

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