Features of the application of neuroprotective therapy for traumatic optic neuropathy in the clinical setting

Background: The features of the application of neuroprotective therapy for traumatic optic neuropathy (TON) in the clinical setting are not known. Methods: Forty-nine TON patients (49 eyes) with MRI evidence of no compressive optic nerve injury were divided into group A (25 patients) and group B...

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Main Author: N.M. Moyseyenko
Format: Article
Language:English
Published: Ukrainian Society of Ophthalmologists 2019-06-01
Series:Journal of Ophthalmology
Subjects:
Online Access:https://www.ozhurnal.com/en/archive/2019/3/8-fulltext
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author N.M. Moyseyenko
author_facet N.M. Moyseyenko
author_sort N.M. Moyseyenko
collection DOAJ
description Background: The features of the application of neuroprotective therapy for traumatic optic neuropathy (TON) in the clinical setting are not known. Methods: Forty-nine TON patients (49 eyes) with MRI evidence of no compressive optic nerve injury were divided into group A (25 patients) and group B (24 patients) and underwent treatment. Patients of group A were treated with 1000 mg of pre-intravenous methylprednisolone daily for 3 days with subsequent gradual tapering of the dose. Patients of group B were treated with a 1000-mg methylprednisolone infusion daily for 3 days and bilateral electric phosphene stimulation (EPS) for 10 days. Results: We demonstrated in the clinical setting that, compared to steroid-only treatment, steroids plus EPS treatment for TON is characterized by greater improvements in (a) visual acuity, (b) selectivity of action depending on the ophthalmoscopic form of TON, and (c) atrophic processes in the axial bundle of the optic nerve. After combination treatment for TON, visual acuity improved by 0.6 to 0.8, and critical frequency of phosphene disappearance (CFPD) improved by 35 to 45 Hz. Compared with combined or inverse form of TON, ischemic form of TON is seen in the earlier period after the traumatic event. Steroids plus EPS treatment effect was greater in the last form than in the two former forms. Conclusion: Our steroids plus EPS treatment may be an alternative to conventional treatment (megadose steroid-only therapy) for TON in the clinical setting.
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spelling doaj.art-8747d0c2b68540cd945f0cac3ce91c7a2023-12-21T14:25:36ZengUkrainian Society of OphthalmologistsJournal of Ophthalmology2412-87402019-06-013414410.31288/oftalmolzh201934144Features of the application of neuroprotective therapy for traumatic optic neuropathy in the clinical settingN.M. Moyseyenko0Ivano-Frankivsk National Medical UniversityBackground: The features of the application of neuroprotective therapy for traumatic optic neuropathy (TON) in the clinical setting are not known. Methods: Forty-nine TON patients (49 eyes) with MRI evidence of no compressive optic nerve injury were divided into group A (25 patients) and group B (24 patients) and underwent treatment. Patients of group A were treated with 1000 mg of pre-intravenous methylprednisolone daily for 3 days with subsequent gradual tapering of the dose. Patients of group B were treated with a 1000-mg methylprednisolone infusion daily for 3 days and bilateral electric phosphene stimulation (EPS) for 10 days. Results: We demonstrated in the clinical setting that, compared to steroid-only treatment, steroids plus EPS treatment for TON is characterized by greater improvements in (a) visual acuity, (b) selectivity of action depending on the ophthalmoscopic form of TON, and (c) atrophic processes in the axial bundle of the optic nerve. After combination treatment for TON, visual acuity improved by 0.6 to 0.8, and critical frequency of phosphene disappearance (CFPD) improved by 35 to 45 Hz. Compared with combined or inverse form of TON, ischemic form of TON is seen in the earlier period after the traumatic event. Steroids plus EPS treatment effect was greater in the last form than in the two former forms. Conclusion: Our steroids plus EPS treatment may be an alternative to conventional treatment (megadose steroid-only therapy) for TON in the clinical setting.https://www.ozhurnal.com/en/archive/2019/3/8-fulltexttraumatic optic neuropathyneuroprotective therapyelectric phosphene stimulation
spellingShingle N.M. Moyseyenko
Features of the application of neuroprotective therapy for traumatic optic neuropathy in the clinical setting
Journal of Ophthalmology
traumatic optic neuropathy
neuroprotective therapy
electric phosphene stimulation
title Features of the application of neuroprotective therapy for traumatic optic neuropathy in the clinical setting
title_full Features of the application of neuroprotective therapy for traumatic optic neuropathy in the clinical setting
title_fullStr Features of the application of neuroprotective therapy for traumatic optic neuropathy in the clinical setting
title_full_unstemmed Features of the application of neuroprotective therapy for traumatic optic neuropathy in the clinical setting
title_short Features of the application of neuroprotective therapy for traumatic optic neuropathy in the clinical setting
title_sort features of the application of neuroprotective therapy for traumatic optic neuropathy in the clinical setting
topic traumatic optic neuropathy
neuroprotective therapy
electric phosphene stimulation
url https://www.ozhurnal.com/en/archive/2019/3/8-fulltext
work_keys_str_mv AT nmmoyseyenko featuresoftheapplicationofneuroprotectivetherapyfortraumaticopticneuropathyintheclinicalsetting