The effect of steroids in combination With optic nerve decompression surgery in traumatic optic neuropathy. (2nd April 2013)

• Record Type: Journal Article
• Authors: Ropposch, Thorsten; Steger, Bernhard; Meço, Cem; Emesz, Martin; Reitsamer, Herbert; Rasp, Gerd; Moser, Gerhard
• Is Part Of: Laryngoscope. Volume 123:Number 5(2013:May)
• Page Start: 1082
• Page End: 1086
• Publication Date: 2013-04-02
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.23845
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary23845-sec-0001" sec-type="section"> <title>Objectives/Hypothesis</title> <p>Traumatic optic neuropathy (TON) is an important cause of severe visual impairment following blunt or penetrating head trauma. Treatment options include steroids, decompression, or both. Studies have failed to show a clear benefit for either steroids or surgery or a combined therapy. This study describes the visual outcome in surgically managed patients with or without steroid treatment.</p> </sec> <sec id="lary23845-sec-0002" sec-type="section"> <title>Study Design</title> <p>Retrospective analysis.</p> </sec> <sec id="lary23845-sec-0003" sec-type="section"> <title>Methods</title> <p>In a retrospective chart review we included patients (n = 42) with TON who were managed with optic nerve decompression surgery with or without steroids. Comparison of initial and final visual acuity was the primary outcome parameter.</p> </sec> <sec id="lary23845-sec-0004" sec-type="section"> <title>Results</title> <p>In 42 consecutive patients, steroids were used in 21 cases (50%). Ten patients received a high‐dose systemic regimen of more than 500 mg methylprednisolone initial dose, and 11 patients were treated with a lower dose. The overall visual improvement rate was 33%, no change was noted in 50%, and no outcome data were available in 17%. The visual improvement rate of patients treated with decompression surgery and steroids was lower (29%, 6 of 21) than those treated with surgery alone (53%, 8 of 15). Comparing both groups, additional steroids had no beneficial effect on the visual outcome (<italic>P</italic> = .97). There was no case with a deterioration of visual function due to therapy.</p> </sec> <sec id="lary23845-sec-0005" sec-type="section"> <title>Conclusions</title> <p>In patients with traumatic optic neuropathy who were treated with optic nerve decompression surgery, steroids had no beneficial effect on the visual outcome.</p> </sec> <sec id="lary23845-sec-0013" sec-type="section"> <title>Level of Evidence</title> <p>2c.</p> </sec> </abstract>