Clinical treatment of traumatic optic neuropathy in children: Summary of 29 cases

Chen,Min; Jiang,Yan; Zhang,Jisheng; Li,Na

doi:10.3892/etm.2018.6637

Clinical treatment of traumatic optic neuropathy in children: Summary of 29 cases

Authors:
- Min Chen
- Yan Jiang
- Jisheng Zhang
- Na Li
View Affiliations

Affiliations: Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
Published online on: August 22, 2018 https://doi.org/10.3892/etm.2018.6637
Pages: 3562-3566

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Clinical features and treatments for traumatic optic neuropathy (TON) in children are reported. Twenty-nine children were enrolled in the Affiliated Hospital of Qingdao University from April 1999 to May 2015 for retrospective analysis. Of these 29 patients, 5 received drug therapy, and 24 received drug therapy combined with surgical therapy. Among the patients who received surgical therapy, 23 received nasal endoscopic optic decompression under general anaesthesia, and 1 received nasal endoscopic orbital decompression under general anaesthesia. All the patients were followed up for at least 6 months. In 29 cases, 48.28% (14/29) had visual improvement. Of the 5 patients who received drug therapy, 3 showed improvement (60%). Of the 24 cases who received drug and surgical therapy, 11 showed improvement (45.83%). Of the 22 patients who lost visual sensitivity, 10 showed improvement (45.45%). Of the 7 cases with visual acuity above basic light sensitivity, 4 showed improvement (57.14%). In conclusion, TON in children can lead to poor diagnosis and prognosis because of the difficulty of examining children and their limited language expression ability. Early ophthalmologic examination is therefore essential for children with craniofacial injuries, and proper treatment should be undertaken as soon as possible.

View Figures

View References

1	Al-Qurainy IA, Stassen LF, Dutton GN, Moos KF and El-Attar A: The characteristics of midfacial fractures and the association with ocular injury: A prospective study. Br J Oral Maxillofac Surg. 29:291–301. 1991. View Article : Google Scholar : PubMed/NCBI
2	Landers MB III, Bradbury MJ and Sydnor CF: Retinal vascular changes in retrograde optic atrophy. Am J Ophthalmol. 86:177–181. 1978. View Article : Google Scholar : PubMed/NCBI
3	McClenaghan FC, Ezra DG and Holmes SB: Mechanisms and management of vision loss following orbital and facial trauma. Curr Opin Ophthalmol. 22:426–431. 2011. View Article : Google Scholar : PubMed/NCBI
4	Nau HE, Gerhard L, Foerster M, Nahser HC, Reinhardt V and Joka T: Optic nerve trauma: Clinical, electrophysiological and histological remarks. Acta Neurochir (Wien). 89:16–27. 1987. View Article : Google Scholar : PubMed/NCBI
5	Kountakis SE, Maillard AA, El-Harazi SM, Longhini L and Urso RG: Endoscopic optic nerve decompression for traumatic blindness. Otolaryngol Head Neck Surg. 123:34–37. 2000. View Article : Google Scholar : PubMed/NCBI
6	Cirovic S, Bhola RM, Hose DR, Howard IC, Lawford PV, Marr JE and Parsons MA: Computer modelling study of the mechanism of optic nerve injury in blunt trauma. Br J Ophthalmol. 90:778–783. 2006. View Article : Google Scholar : PubMed/NCBI
7	Steinsapir KD and Goldberg RA: Traumatic optic neuropathy: An evolving understanding. Am J Ophthalmol. 151:928–933.e2. 2011. View Article : Google Scholar : PubMed/NCBI
8	Yu-Wai-Man P: Traumatic optic neuropathy - clinical features and management issues. Taiwan J Ophthalmol. 5:3–8. 2015. View Article : Google Scholar : PubMed/NCBI
9	Goldenberg-Cohen N, Miller NR and Repka MX: Traumatic optic neuropathy in children and adolescents. J AAPOS. 8:20–27. 2004. View Article : Google Scholar : PubMed/NCBI
10	Ford RL, Lee V, Xing W and Bunce C: A 2-year prospective surveillance of pediatric traumatic optic neuropathy in the United Kingdom. J AAPOS. 16:413–417. 2012. View Article : Google Scholar : PubMed/NCBI
11	Gupta AK, Gupta AK, Gupta A and Malhotra SK: Traumatic optic neuropathy in pediatric population: Early intervention or delayed intervention? Int J Pediatr Otorhinolaryngol. 71:559–562. 2007. View Article : Google Scholar : PubMed/NCBI
12	Andersen MR and Gade E: Traumatic optic neuropathy after fall with a bamboo stick. Ugeskr Laeger. 176:V051303302014.(In Danish). PubMed/NCBI
13	Entezari M, Esmaeili M and Yaseri M: A pilot study of the effect of intravenous erythropoetin on improvement of visual function in patients with recent indirect traumatic optic neuropathy. Graefes Arch Clin Exp Ophthalmol. 252:1309–1313. 2014. View Article : Google Scholar : PubMed/NCBI
14	Connick P, Kolappan M, Crawley C, Webber DJ, Patani R, Michell AW, Du MQ, Luan SL, Altmann DR, Thompson AJ, et al: Autologous mesenchymal stem cells for the treatment of secondary progressive multiple sclerosis: An open-label phase 2a proof-of-concept study. Lancet Neurol. 11:150–156. 2012. View Article : Google Scholar : PubMed/NCBI
15	Yu-Wai-Man P and Griffiths PG: Steroids for traumatic optic neuropathy. Cochrane Database Syst Rev. 6:CD006032. 2013.PubMed/NCBI
16	Vaitheeswaran K, Kaur P and Garg S: Minimal invasive transcaruncular optic canal decompression for traumatic optic neuropathy. Orbit. 33:456–458. 2014. View Article : Google Scholar : PubMed/NCBI
17	Spoor TC, Hartel WC, Lensink DB and Wilkinson MJ: Treatment of traumatic optic neuropathy with corticosteroids - correction. Am J Ophthalmol. 111:5261991. View Article : Google Scholar : PubMed/NCBI
18	Sandu K, Monnier P and Pasche P: Anatomical landmarks for transnasal endoscopic skull base surgery. Eur Arch Otorhinolaryngol. 269:171–178. 2012. View Article : Google Scholar : PubMed/NCBI