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Research Journal of Medical Sciences

ISSN: Online 1993-6095
ISSN: Print 1815-9346
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Visual Outcomes and Prognostic Factors in Patients with Indirect Traumatic Optic Neuropathy Treated with Steroids: A Prospective Analysis

S. Ashwani Siddardha, Vijay Prakash Kinikar, A. Venkata Pitchi Reddy and B. Sushma
Page: 401-406 | Received 28 Aug 2024, Published online: 30 Sep 2024

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https://doi.org/10.36478/10.36478/makrjms.2024.10.401.406

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Abstract

Indirect traumatic optic neuropathy (ITON) is a rare but serious condition resulting from blunt trauma to the head or face, causing visual impairment without direct optic nerve damage. The effectiveness of corticosteroid therapy in improving visual outcomes remains debated. This study evaluates steroid therapy's impact on visual recovery in ITON and examines key prognostic factors influencing outcomes. Aim of the study is to assess visual outcomes at 3 months in ITON patients treated with steroids and identify prognostic factors such as initial best corrected visual acuity (BCVA), timing of treatment, age and loss of consciousness. This prospective observational study included 50 ITON patients treated with high‐dose corticosteroids. Patients were categorized based on the timing of treatment and initial BCVA. Visual outcomes were measured at baseline and at 3 months. Factors such as age, loss of consciousness and fundus findings were analyzed using chi‐square and logistic regression tests. A p‐value <0.05 was considered significant. At 3 months, 46% of patients showed visual improvement, while 54% had no improvement. A significant association was found between earlier steroid administration (within 48 hours) and better visual recovery (p<0.05). Improvement was seen in 71% of patients with BCVA better than 6/60‐CF, but none in those with no light perception (No PL). Age and loss of consciousness were not significantly associated with outcomes (p>0.05). At 3 months, 48% of patients showed optic atrophy and 32% had temporal pallor. Early steroid treatment within 48 hours of injury is associated with better visual outcomes in ITON patients, particularly those with residual vision. Patients with no light perception at presentation have a poor prognosis. Age and loss of consciousness did not significantly influence outcomes. Further research is needed for alternative treatments in non‐responders.

How to cite this article:

S. Ashwani Siddardha, Vijay Prakash Kinikar, A. Venkata Pitchi Reddy and B. Sushma. Visual Outcomes and Prognostic Factors in Patients with Indirect Traumatic Optic Neuropathy Treated with Steroids: A Prospective Analysis.
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.10.401.406
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2024.10.401.406