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Traumatic dysfunction of the optic chiasm.

Pepin William Atipo-Tsiba1, François-Xavier Borruat

  • 1Hôpital Ophtalmique Jules Gonin, Neuro-Ophthalmology Unit, Lausanne Switzerland.

Klinische Monatsblatter Fur Augenheilkunde
|March 29, 2003
PubMed
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Traumatic optic neuropathy involving the optic chiasm is more common than previously thought, affecting 11% of patients. Visual outcomes are often poor due to severe head trauma.

Area of Science:

  • Neuro-ophthalmology
  • Trauma research
  • Neurological disorders

Background:

  • Optic chiasm trauma is infrequently reported.
  • Previous literature suggests a low incidence of optic chiasm involvement in traumatic optic neuropathy.
  • Understanding the epidemiology and clinical features of optic chiasm trauma is crucial.

Purpose of the Study:

  • To determine the incidence of optic chiasm involvement in patients with traumatic optic neuropathy.
  • To describe the clinical characteristics and visual prognosis of optic chiasm trauma.
  • To evaluate the diagnostic subtlety of visual field defects in these cases.

Main Methods:

  • Retrospective review of patients diagnosed with traumatic optic neuropathy (TON) between 1992 and 2002.
  • Analysis of patient demographics, injury mechanisms, neurological status, and visual outcomes.

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  • Identification of cases with confirmed optic chiasm involvement.

    • Main Results:

    • Out of 91 patients with TON, 10 (11%) exhibited optic chiasm involvement.
    • All affected patients were male, with an average age of 32 years.
    • Injuries were primarily due to rapid deceleration (e.g., accidents, falls); 6 patients had coma, and 8 had other neurological deficits. Optic neuropathy was present in 80% of these cases.
    • Visual improvement occurred in only two patients with milder head trauma.

    Conclusions:

    • Optic chiasm dysfunction following head trauma is more prevalent than previously assumed.
    • Visual field defects can be subtle or obvious, complicating diagnosis.
    • The visual prognosis is generally poor, likely linked to the severity of the head injury.