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Traumatic optic neuropathy: a review of current studies

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Abstract

Traumatic optic neuropathy (TON) is a serious complication of craniofacial trauma that directly or indirectly damages the optic nerve and can cause severe vision loss. The incidence of TON has been gradually increasing in recent years. Research on the protection and regeneration of the optic nerve after the onset of TON is still at the level of laboratory studies and which is insufficient to support clinical treatment of TON. And, due to without clear guidelines, there is much ambiguity regarding its diagnosis and management. Clinical interventions for TON include observation only, treatment with corticosteroids alone, or optic canal (OC) decompression (with or without steroids). There is controversy in clinical practice concerning which treatment is the best. A review of available studies shows that the visual acuity of patients with TON can be significantly improved after OC decompression surgery (especially endoscopic transnasal/transseptal optic canal decompression (ETOCD)) with or without the use of corticosteroids. And new findings of laboratory studies such as mitochondrial therapy, lipid change studies, and other studies in favor of TON therapy have also been identified. In this review, we discuss the evolving perspective of surgical treatment and experimental study.

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All data are available from the corresponding open web (http://www.metabolomicsworkbench.org).

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Authors and Affiliations

  1. Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China

    Bin Chen, Hengsen Zhang & Yong Wang

  2. Department of Cellular and Molecular Anatomy, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan

    Bin Chen, Hengsen Zhang & Qing Zhai

  3. Department of Gastrointestinal Surgery, Shenyang Sujiatun District Central Hospital, Shenyang, Liaoning, China

    Huaipeng Li

  4. Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, Liaoning, China

    Chunxia Wang

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  1. Bin Chen
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  2. Hengsen Zhang
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  3. Qing Zhai
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  4. Huaipeng Li
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  5. Chunxia Wang
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  6. Yong Wang
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Yong Wang is the chief of this case and final approval of the version. Bin Chen wrote the paper. Hengsen Zhang, Qing Zhai, Huaipeng Li, and Chunxia Wang reviewed and edited the manuscript. All authors read and approved the manuscript.

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Correspondence to Yong Wang.

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Chen, B., Zhang, H., Zhai, Q. et al. Traumatic optic neuropathy: a review of current studies. Neurosurg Rev 45, 1895–1913 (2022). https://doi.org/10.1007/s10143-021-01717-9

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