State of the art on traumatic optic neuropathy

Abstract

Traumatic optic neuropathy (TON) is an uncommon cause of permanent visual loss. Optic nerve trauma may be direct or indirect (the latter being the more common as a cause of TON). The intracanalicular portion of the optic nerve is the most frequent site of injury in cases of indirect TON, probably related to a mechanism of shear, ischemia, axonal swelling, reperfusion and reactive oxygen species formation with lipidperoxidation. In this review we summarize the clinical signs and symptoms that must be evaluated for a correct diagnosis, supported by instrumental investigations such as neuroradiological imaging. In the last part of the work we report the visual prognosis and the treatment options available to date for TON.

Keywords::

• apoptosis
• axonal lipidperoxidation
• head trauma
• optic canal decompression
• steroids megadose
• traumatic brain injury
• traumatic optic neuropathy

Acknowledgement

The authors thank Sarah Weatherley for technical assistance in reviewing the English version of this paper.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.