Megadose Steroids and Intranasal Optic Nerve Decompression in the Treatment of Traumatic Optic Neuropathy

다국어 초록 (Multilingual Abstract)

Background and Objectives：Traumatic optic neuropathy (TON) is a relatively rare complication associated with closedhead injury. However, it represents an extremely poor prognosis, and its management remains controversial. We present thetreatment results of 15 patients with immediate and complete TON who were treated with megadose steroids (MDS), and, incases where MDS produced no response, intranasal optic nerve decompression (OND). Patients and Methods：The diagnosisof TON was based on evidence of the following：complete loss of vision, absence of direct pupillary light reflex and intact consensualresponse. All of the patients underwent high resolution CT scans of the orbit and received a complete neuro-opthalmologicexamination. MDS was started immediately after the diagnosis. If no response occurred by 48 hours, an intranasal ONDwas conducted. Results：Two of the 15 patients exhibited improved vision after treatment with MDS, and six of the remaining13 patients who were unresponsive to MDS demonstrated improved vision after OND. Overall, eight out of the 15 patients experiencedimproved vision. Conclusion：This study is uncontrolled, but suggests that our protocol of MDS and, in cases wherethis produced no response, OND may be an effective and valid treatment modality for patients with immediate complete TON,which is generally believed to represent an extremely poor prognosis regardless of treatment.