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Ocular Therapeutic Delivery and Advanced Tissue Retrieval in Adult Rats
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Steroids for traumatic optic neuropathy.

Patrick Yu-Wai-Man1, Philip G Griffiths

  • 1Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK. patrick.yu-wai-man@ncl.ac.uk.

The Cochrane Database of Systematic Reviews
|June 18, 2013
PubMed
Summary
This summary is machine-generated.

Steroids do not appear to improve vision in traumatic optic neuropathy (TON). Current evidence suggests steroids may even be harmful, necessitating individual patient assessment and informed consent for treatment. Further research is crucial.

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Area of Science:

  • Ophthalmology
  • Neurology
  • Trauma Care

Background:

  • Traumatic optic neuropathy (TON) causes significant vision loss after head injuries.
  • Optic nerve swelling can lead to secondary retinal ganglion cell damage.
  • Decompression, steroids, or surgery are considered for improving visual prognosis in TON.

Purpose of the Study:

  • To evaluate the effectiveness and safety of steroid use in traumatic optic neuropathy.
  • To analyze visual outcomes in TON patients treated with steroids.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) comparing steroids (alone or with surgery) to surgery alone or no treatment.
  • Searched multiple databases including CENTRAL, MEDLINE, EMBASE, LILACS, and trial registries.
  • Included one double-masked, placebo-controlled RCT of high-dose intravenous steroids in indirect TON.

Main Results:

  • One RCT with 31 participants (16 steroids, 15 placebo) met criteria.
  • No statistically significant difference in final visual acuity (LogMAR) between steroid and placebo groups (P=0.13).
  • Improvement in visual acuity occurred in 68.8% of the steroid group vs. 53.3% of the placebo group, not statistically significant (P=0.38).

Conclusions:

  • High spontaneous visual recovery rates exist in TON.
  • No convincing evidence supports steroids providing additional visual benefit over observation.
  • Potential detrimental effects of steroids warrant further investigation and careful individual assessment.