Prognosticators of Visual Acuity After Indirect Traumatic Optic Neuropathy.
Prognosticators of Visual Acuity After Indirect Traumatic Optic Neuropathy.
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DOI：
10.1097/wno.0000000000001521
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发表时间：
2022-06-01
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背景：本研究的目的是确定是否有影像学和全身的临床特征，可以预测最终的视觉结果在患者间接创伤性视神经病变（iTON）。方法：本研究是一个回顾性的，多中心的病例系列的成人患者iTON治疗最初在大型，城市，和/或学术创伤中心与后续在附属眼科诊所。除了详细的头颅计算机断层扫描特征外，还收集了人口统计学、全身合并症、合并伤、给予的血液制品和颅内压以及沿着其他因素。LogMAR视力（VA）在最初的介绍到医院，并长达12个月的后续counted.Results：20例患者符合纳入标准，16（80%）是男性，平均年龄为40.9岁（±20.9）。平均初始VA为1.61 logMAR（20/800，±0.95），最终VA为1.31 logMAR（20/400，±1.06）。3例患者（4只眼）就诊时无光感（NLP）VA，最终随访时仍为NLP。在分析的预测因子中，只有初始视力被认为是视力结果的重要预测因子。眼眶骨折，锥体内和/或锥体外出血，以及全身合并症的存在下，没有发现显着影响视力outcome.Conclusions：在评估多个因素，初始VA是唯一的因素与视力预后在iTON。这些知识可以更好地使临床医生预测视力预后，并在受伤时与患者和家属建立合理的期望。
Background:The purpose of this study is to determine whether there are radiographic and systemic clinical characteristics that can predict final visual outcomes in patients with indirect traumatic optic neuropathy (iTON).Methods:This study is a retrospective, multicenter case series of adult patients with iTON treated initially at large, urban, and/or academic trauma centers with follow-up at an affiliated ophthalmology clinic. In addition to detailed cranial computed tomography characteristics, demographics, systemic comorbidities, coinjuries, blood products administered, and intracranial pressure, along with other factors, were gathered. LogMAR visual acuity (VA) at the initial presentation to the hospital and up to 12 months follow-up was collected.Results:Twenty patients met inclusion criteria; 16 (80%) were men with a mean age of 40.9 years (±20.9). Mean initial VA was 1.61 logMAR (∼ 20/800,±0.95), and final VA was 1.31 logMAR (∼ 20/400,±1.06). Three patients (4 eyes) had no light perception (NLP) VA at presentation and remained NLP at final follow-up. Of the predictors analyzed, only the initial VA was found to be a significant predictor of visual outcome. The presence of orbital fractures, intraconal and/or extraconal hemorrhage, as well as systemic comorbidities, were not found to significantly affect visual outcome.Conclusions:After evaluating multiple factors, initial VA was the only factor associated with visual prognosis in iTON. This knowledge may better enable clinicians to predict visual prognosis and set reasonable expectations with patients and families at the time of injury.