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Combination analysis on the impact of the initial vision and surgical time for the prognosis of indirect traumatic optic neuropathy after endoscopic transnasal optic canal decompression

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Abstract

To analyze the impact of the initial vision and surgical time for endoscopic transnasal/transethmosphenoid optic canal decompression (ETOCD) in the treatment of indirect traumatic optic neuropathy (TON). This retrospective case series analysis included 72 patients with indirect TON who underwent ETOCD from August 2017 to May 2019. Visual acuity (VA) was compared before and after surgery to estimate the improvement rate. The overall VA improvement rate of ETOCD was 54.2%. There were 83.3% and 33.3% improvement rate of patients with residual vision and blindness, respectively. VA was improved in 60.9% of patients treated within 3 days, 61.5% treated within 7 days, and 35.0% treated later than 7 days. Of the blindness patients, 50.0%, 37.5%, and 0.0% were treated within 3 days, 3–7 days, and later than 7 days, respectively. Of patients with residual vision, 85.7%, 92.3%, and 70.0% were treated within 3 days, 3–7 days, and later than 7 days, respectively. A statistically significant difference was found between patients with residual vision and those with blindness (P < 0.01), as well as between patients who received ETOCD within 7 days and those who received ETOCD later than 7 days (P = 0.043). The improvement rate of blindness patients managed within 3 days (P = 0.008) and 3–7 days (P = 0.035) was significantly higher than that for patients managed beyond 7 days. Indirect TON patients can directly benefit from ETOCD, and patients with residual vision have better improvement rates. ETOCD should be performed as soon as possible to salvage the patient’s VA, especially within the first 7 days. For blindness patients, it is necessary to carry out the surgery within 7 days with increased benefit seen before 3 days.

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References

  1. Guy WM, Soparkar CN, Alford EL, Patrinely JR, Sami MS, Parke RB (2014) Traumatic optic neuropathy and second optic nerve injuries. JAMA Ophthalmol 132(5):567–571

    PubMed  Google Scholar 

  2. Bodanapally UK, Van der Byl G, Shanmuganathan K et al (2014) Traumatic optic neuropathy prediction after blunt facial trauma: derivation of a risk score based on facial CT findings at admission. Radiology. 272(3):824–831

    PubMed  Google Scholar 

  3. Sarkies N (2004) Traumatic optic neuropathy. Eye (Lond). 18(11):1122–1125

    CAS  PubMed  Google Scholar 

  4. Levin LA, Beck RW, Joseph MP, Seiff S, Kraker R (1999) The treatment of traumatic optic neuropathy: the International Optic Nerve Trauma Study. Ophthalmology. 106(7):1268–1277

    CAS  PubMed  Google Scholar 

  5. Lee V, Ford RL, Xing W, Bunce C, Foot B (2010) Surveillance of traumatic optic neuropathy in the UK. Eye (Lond) 24(2):240–250

    CAS  Google Scholar 

  6. Pirouzmand F (2012) Epidemiological trends of traumatic optic nerve injuries in the largest Canadian adult trauma center. J Craniofac Surg 23(2):516–520

    PubMed  Google Scholar 

  7. Chaon BC, Lee MS (2015) Is there treatment for traumatic optic neuropathy? Curr Opin Ophthalmol 26(6):445–449

    PubMed  Google Scholar 

  8. Yang Y, Wang H, Shao Y, Wei Z, Zhu S, Wang J (2006) Extradural anterior clinoidectomy as an alternative approach for optic nerve decompression: anatomic study and clinical experience. Neurosurgery 59(4 Suppl 2):ONS253–62 discussion ONS262

    Google Scholar 

  9. Lai IL, Liao HT (2018) Risk factor analysis for the outcomes of indirect traumatic optic neuropathy with no light perception at initial visual acuity testing. World Neurosurg 115:e620–e628

    PubMed  Google Scholar 

  10. Otani N, Wada K, Fujii K, Toyooka T, Kumagai K, Ueno H, Tomura S, Tomiyama A, Nakao Y, Yamamoto T, Mori K (2016) Usefulness of extradural optic nerve decompression via trans-superior orbital fissure approach for treatment of traumatic optic nerve injury: surgical procedures and techniques from experience with 8 consecutive patients. World Neurosurg. 90:357–363

    PubMed  Google Scholar 

  11. He Z, Li Q, Yuan J, Zhang X, Gao R, Han Y, Yang W, Shi X, Lan Z (2015) Evaluation of transcranial surgical decompression of the optic canal as a treatment option for traumatic optic neuropathy. Clin Neurol Neurosurg 134:130–135

    PubMed  Google Scholar 

  12. Chen CT, Huang F, Tsay PK et al (2007) Endoscopically assisted transconjunctival decompression of traumatic optic neuropathy. J Craniofac Surg. 18(1):19–26 discussion 27-8

    CAS  PubMed  Google Scholar 

  13. Thakar A, Mahapatra AK, Tandon DA (2003) Delayed optic nerve decompression for indirect optic nerve injury. Laryngoscope. 113(1):112–119

    CAS  PubMed  Google Scholar 

  14. Lübben B, Stoll W, Grenzebach U (2001) Optic nerve decompression in the comatose and conscious patients after trauma. Laryngoscope. 111(2):320–328

    PubMed  Google Scholar 

  15. Li KK, Teknos TN, Lai A, Lauretano A, Terrell J, Joseph MP (1999) Extracranial optic nerve decompression: a 10-year review of 92 patients. J Craniofac Surg. 10(5):454–459

    CAS  PubMed  Google Scholar 

  16. Mine S, Yamakami I, Yamaura A, Hanawa K, Ikejiri M, Mizota A, Adachi-Usami E (1999) Outcome of traumatic optic neuropathy. Comparison between surgical and nonsurgical treatment. Acta Neurochir 141(1):27–30

    CAS  PubMed  Google Scholar 

  17. Li KK, Teknos TN, Lai A, Lauretano AM, Joseph MP (1999) Traumatic optic neuropathy: result in 45 consecutive surgically treated patients. Otolaryngol Head Neck Surg. 120(1):5–11

    CAS  PubMed  Google Scholar 

  18. Joseph MP, Lessell S, Rizzo J, Momose KJ (1990) Extracranial optic nerve decompression for traumatic optic neuropathy. Arch Ophthalmol 108(8):1091–1093

    CAS  PubMed  Google Scholar 

  19. Levin LA, Joseph MP, Rizzo JF 3rd, Lessell S (1994) Optic canal decompression in indirect optic nerve trauma. Ophthalmology. 101(3):566–569

    CAS  PubMed  Google Scholar 

  20. Zhilin G, Huoniu O, Zhihua C, Guorong D (2011) Wide optic nerve canal decompression for the treatment of blindness resulting from an indirect optic nerve injury. J Craniofac Surg. 22(4):1463–1465

    PubMed  Google Scholar 

  21. Kong DS, Shin HJ, Kim HY, Chung SK, Nam DH, Lee JI, Park K, Kim JH (2011) Endoscopic optic canal decompression for compressive optic neuropathy. J Clin Neurosci 18(11):1541–1545

    PubMed  Google Scholar 

  22. Chen C, Selva D, Floreani S, Wormald PJ (2006) Endoscopic optic nerve decompression for traumatic optic neuropathy: an alternative. Otolaryngol Head Neck Surg 135(1):155–157

    PubMed  Google Scholar 

  23. Chen M, Jiang Y, Zhang J, Li N (2018) Clinical treatment of traumatic optic neuropathy in children: summary of 29 cases. Exp Ther Med 16(4):3562–3566

    PubMed  PubMed Central  Google Scholar 

  24. Ropposch T, Steger B, Meço C, Emesz M, Reitsamer H, Rasp G, Moser G (2013) The effect of steroids in combination with optic nerve decompression surgery in traumatic optic neuropathy. Laryngoscope. 123(5):1082–1086

    CAS  PubMed  Google Scholar 

  25. Xie D, Yu H, Ju J, Zhang L (2017) The outcome of endoscopic optic nerve decompression for bilateral traumatic optic neuropathy. J Craniofac Surg. 28(4):1024–1026

    PubMed  Google Scholar 

  26. Horiguchi K, Murai H, Hasegawa Y, Mine S, Yamakami I, Saeki N (2010) Endoscopic endonasal trans-sphenoidal optic nerve decompression for traumatic optic neuropathy--technical note. Neurol Med Chir (Tokyo) 50(6):518–522

    Google Scholar 

  27. Wang DH, Zheng CQ, Qian J, Barr JJ, Anderson AG Jr (2008) Endoscopic optic nerve decompression for the treatment of traumatic optic nerve neuropathy. ORL J Otorhinolaryngol Relat Spec 70(2):130–133

    PubMed  Google Scholar 

  28. Jiang RS, Hsu CY, Shen BH (2001) Endoscopic optic nerve decompression for the treatment of traumatic optic neuropathy. Rhinology. 39(2):71–74

    CAS  PubMed  Google Scholar 

  29. Kountakis SE, Maillard AAJ, Urso R, Stiernberg CM (1997) Endoscopic approach to traumatic visual loss. Otolaryngol Head Neck Surg. 116(6):652–655

    CAS  PubMed  Google Scholar 

  30. Ma YJ, Yu B, Tu YH, Mao BX, Yu XY, Wu WC (2018) Prognostic factors of trans-ethmosphenoid optic canal decompression for indirect traumatic optic neuropathy. Int J Ophthalmol 11(7):1222–1226

    PubMed  PubMed Central  Google Scholar 

  31. Yu B, Ma Y, Tu Y, Wu W (2016) The outcome of endoscopic transethmosphenoid optic canal decompression for indirect traumatic optic neuropathy with no-light-perception. J Ophthalmol 2016:6492858

    PubMed  PubMed Central  Google Scholar 

  32. Yan W, Chen Y, Qian Z, Selva D, Pelaez D, Tu Y, Wu W (2017) Incidence of optic canal fracture in the traumatic optic neuropathy and its effect on the visual outcome. Br J Ophthalmol 101(3):261–267

    PubMed  Google Scholar 

  33. Thaker A, Tandon DA, Mahapatra AK (2009) Surgery for optic nerve injury: should nerve sheath incision supplement osseous decompression? Skull Base 19(4):263–271

    PubMed  PubMed Central  Google Scholar 

  34. Xu R, Chen F, Zuo K, Ye X, Yang Q, Shi J, Chen H, Li H (2014) Endoscopic optic nerve decompression for patients with traumatic optic neuropathy: is nerve sheath incision necessary? ORL J Otorhinolaryngol Relat Spec 76(1):44–49

    PubMed  Google Scholar 

  35. Song Y, Li H, Ma Y, Li W, Zhang X, Pan X, Tan G (2013) Analysis of prognostic factors of endoscopic optic nerve decompression in traumatic blindness. Acta Otolaryngol 133(11):1196–1200

    PubMed  Google Scholar 

  36. Yang QT, Zhang GH, Liu X, Ye J, Li Y (2012) The therapeutic efficacy of endoscopic optic nerve decompression and its effects on the prognoses of 96 cases of traumatic optic neuropathy. J Trauma Acute Care Surg 72(5):1350–1355

    PubMed  Google Scholar 

  37. Li HB, Shi JB, Cheng L, Yun O, Xu G (2007) Salvage optic nerve decompression for traumatic blindness under nasal endoscopy: risk and benefit analysis. Clin Otolaryngol 32(6):447–451

    CAS  PubMed  Google Scholar 

  38. Kountakis SE, Maillard AA, El-Harazi SM, Longhini L, Urso RG (2000) Endoscopic optic nerve decompression for traumatic blindness. Otolaryngol Head Neck Surg. 123(1 Pt 1):34–37

    CAS  PubMed  Google Scholar 

  39. Emanuelli E, Bignami M, Digilio E, Fusetti S, Volo T, Castelnuovo P (2015) Post-traumatic optic neuropathy: our surgical and medical protocol. Eur Arch Otorhinolaryngol 272(11):3301–3309

    CAS  PubMed  Google Scholar 

  40. Peng A, Li Y, Hu P, Wang Q (2011) Endoscopic optic nerve decompression for traumatic optic neuropathy in children. Int J Pediatr Otorhinolaryngol 75(8):992–998

    PubMed  Google Scholar 

  41. Gupta AK, Gupta AK, Gupta A, Malhotra SK (2007) Traumatic optic neuropathy in pediatric population: early intervention or delayed intervention? Int J Pediatr Otorhinolaryngol 71(4):559–562

    PubMed  Google Scholar 

  42. Yu B, Chen Y, Ma Y, Tu Y, Wu W (2018) Outcome of endoscopic trans-ethmosphenoid optic canal decompression for indirect traumatic optic neuropathy in children. BMC Ophthalmol 18(1):152

    PubMed  PubMed Central  Google Scholar 

  43. Li H, Zhou B, Shi J, Cheng L, Wen W, Xu G (2008) Treatment of traumatic optic neuropathy: our experience of endoscopic optic nerve decompression. J Laryngol Otol 122(12):1325–1329

    CAS  PubMed  Google Scholar 

  44. Yang WG, Chen CT, Tsay PK, de Villa GH, Tsai YJ, Chen YR (2004) Outcome for traumatic optic neuropathy--surgical versus nonsurgical treatment. Ann Plast Surg 52(1):36–42

    PubMed  Google Scholar 

  45. Rajiniganth MG, Gupta AK, Gupta A, Bapuraj JR (2003) Traumatic optic neuropathy: visual outcome following combined therapy protocol. Arch Otolaryngol Head Neck Surg. 129(11):1203–1206

    CAS  PubMed  Google Scholar 

  46. Dhaliwal SS, Sowerby LJ, Rotenberg BW (2016) Timing of endoscopic surgical decompression in traumatic optic neuropathy: a systematic review of the literature. Int Forum Allergy Rhinol 6(6):661–667

    PubMed  Google Scholar 

  47. Carta A, Ferrigno L, Salvo M, Bianchi-Marzoli S, Boschi A, Carta F (2003) Visual prognosis after indirect traumatic optic neuropathy. J Neurol Neurosurg Psychiatry 74(2):246–248

    CAS  PubMed  PubMed Central  Google Scholar 

  48. Lai IL, Liao HT, Chen CT (2016) Risk factors analysis for the outcome of indirect traumatic optic neuropathy with steroid pulse therapy. Ann Plast Surg 76(Suppl 1):S60–S67

    CAS  PubMed  Google Scholar 

  49. Entezari M, Rajavi Z, Sedighi N, Daftarian N, Sanagoo M (2007) High-dose intravenous methylprednisolone in recent traumatic optic neuropathy; a randomized double-masked placebo-controlled clinical trial. Graefes Arch Clin Exp Ophthalmol 245(9):1267–1271

    CAS  PubMed  Google Scholar 

  50. Carta A, Ferrigno L, Leaci R, Kosmarikou A, Zola E, Gomarasca S (2006) Long-term outcome after conservative treatment of indirect traumatic optic neuropathy. Eur J Ophthalmol 16(6):847–850

    CAS  PubMed  Google Scholar 

  51. Steinsapir KD (2006) Treatment of traumatic optic neuropathy with high-dose corticosteroid. J Neuroophthalmol 26(1):65–67

    PubMed  Google Scholar 

  52. Agarwal A, Mahapatra AK (1999) Visual outcome in optic nerve injury patients without initial light perception. Indian J Ophthalmol 47(4):233–236

    CAS  PubMed  Google Scholar 

  53. Lee KF, Muhd Nor NI, Yaakub A, Wan Hitam WH (2010) Traumatic optic neuropathy: a review of 24 patients. Int J Ophthalmol. 3(2):175–178

    PubMed  PubMed Central  Google Scholar 

  54. Chen HY, Tsai RK, Wang HZ (1998) Intravenous methylprednisolone in treatment of traumatic optic neuropathy. Kaohsiung J Med Sci 14(9):577–583

    CAS  PubMed  Google Scholar 

  55. Sefi-Yurdakul N, Koç F (2018) Risk factors affecting the visual outcome in patients with indirect traumatic optic neuropathy. Int Ophthalmol 38(4):1647–1652

    PubMed  Google Scholar 

  56. Sosin M, De La Cruz C, Mundinger GS et al (2016) Treatment outcomes following traumatic optic neuropathy. Plast Reconstr Surg 137(1):231–238

    CAS  PubMed  Google Scholar 

  57. Yip CC, Chng NW, Au Eong KG, Heng WJ, Lim TH, Lim WK (2002) Low-dose intravenous methylprednisolone or conservative treatment in the management of traumatic optic neuropathy. Eur J Ophthalmol 12(4):309–314

    CAS  PubMed  Google Scholar 

  58. Abhinav K, Acosta Y, Wang WH et al (2015) Endoscopic endonasal approach to the optic canal: anatomic considerations and surgical relevance. Neurosurgery. 11(Suppl 3):431–445

    PubMed  Google Scholar 

  59. Berhouma M, Jacquesson T, Abouaf L, Vighetto A, Jouanneau E (2014) Endoscopic endonasal optic nerve and orbital apex decompression for nontraumatic optic neuropathy: surgical nuances and review of the literature. Neurosurg Focus 37(4):E19

    PubMed  Google Scholar 

  60. Di Somma A, Cavallo LM, de Notaris M et al (2017) Endoscopic endonasal medial-to-lateral and transorbital lateral-to-medial optic nerve decompression: an anatomical study with surgical implications. J Neurosurg 127(1):199–208

    PubMed  Google Scholar 

  61. Cook MW, Levin LA, Joseph MP, Pinczower EF (1996) Traumatic optic neuropathy. A meta-analysis. Arch Otolaryngol Head Neck Surg 122(4):389–392

    CAS  PubMed  Google Scholar 

  62. Shi W, Wang HZ, Song WX, Yang WL, Li WY, Wang NL (2013) Axonal loss and blood flow disturbances in the natural course of indirect traumatic optic neuropathy. Chin Med J 126(7):1292–1297

    PubMed  Google Scholar 

  63. Yu-Wai-Man P, Griffiths PG (2013) Surgery for traumatic optic neuropathy. Cochrane Database Syst Rev 6:CD005024

    PubMed  Google Scholar 

  64. He ZH, Lan ZB, Xiong A, Hou GK, Pan YW, Li Q, Zhang XD (2016) Endoscopic decompression of the optic canal for traumatic optic neuropathy. Chin J Traumatol 19(6):330–332

    PubMed  PubMed Central  Google Scholar 

  65. Mahapatra A (1992) Optic nerve injury in children. A prospective study of 35 patients. J Neurosurg Sci 36(2):79–84

    CAS  PubMed  Google Scholar 

  66. Wohlrab TM, Maas S, de Carpentier JP (2002) Surgical decompression in traumatic optic neuropathy. Acta Ophthalmol Scand 80(3):287–293

    PubMed  Google Scholar 

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Funding

This work was supported by the grants of the Major Research and Development Project of Zhejiang Province (No. 2017C03021) and Medical Health Science and Technology Project of Zhejiang Province (No. 2018ZD018).

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  1. Wei Yan and Jingquan Lin contributed equally to this work as co-first author.

Authors and Affiliations

  1. Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China

    Wei Yan, Jingquan Lin, Wanglu Hu, Qun Wu & Jianmin Zhang

  2. Brain Research Institute, Zhejiang University, Hangzhou, Zhejiang, China

    Jianmin Zhang

  3. Collaborative Innovation Center for Brain Science, Zhejiang University, Hangzhou, Zhejiang, China

    Jianmin Zhang

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  1. Wei Yan
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Correspondence to Jianmin Zhang.

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Yan, W., Lin, J., Hu, W. et al. Combination analysis on the impact of the initial vision and surgical time for the prognosis of indirect traumatic optic neuropathy after endoscopic transnasal optic canal decompression. Neurosurg Rev 44, 945–952 (2021). https://doi.org/10.1007/s10143-020-01273-8

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