OCR Text |
Show Journal of Neuro- Ophthalmology 21( 1): 72, 2001. © 2001 Lippincott Williams & Wilkins, Inc., Philadelphia European Literature Abstract H. Esriel Killer, MD High- Dose Steroid Therapy of Traumatic Optic Neuropathy May Fail To Protect the Optic Nerve Permanently. Mariak Z, Obuchowska I, Mariak Z, Stankiewicz A, Ustymowicz A, Proniewska- Skretek E. Neuro- Ophthalmology 1999; 21: 255- 60. [ Reprint requests to Zofia Mariak, MD, Klinika Okulistyczna PSK, Ul. M. C. Sklodowskiej 24a, 15- 276 Bialystok, Poland.] The management of traumatic optic neuropathy ( TON) is still controversial. The range of therapy includes decompression of the optic canal, optic nerve sheath fenestration, high- dose steroids, and doing nothing. Mariak et al. studied the effect of high- dose steroid therapy ( 20 mg of dexamethasone every 6 hours, tapered after 24 hours to 24 mg/ d) in 15 patients with TON. The patients presented for follow- up examination 3 to 11 years after injury. In 6 patients, visual acuity was no light perception before and after treatment. In two patients, visual acuity improved from light perception to 5/ 50 ( 5/ 10, respectively), and in one patient visual acuity improved from light perception to 5/ 7 shortly after the treatment. At the last examination, however, only the patient with 3/ 50 vision remained stable, and the other two patients were back to light perception. The result of this study seems to confirm that bad vision in patients with TON is a lasting problem, and that the improvement after steroid medication may be only of limited benefit. 72 |