Traumatic optic neuropathy: facial CT findings affecting visual acuity

Area of Science:

• Ophthalmology
• Radiology
• Trauma Surgery

Background:

• Traumatic optic neuropathy (TON) can lead to significant vision impairment.
• Early identification of patients at risk for severe visual loss is crucial for timely intervention.

Purpose of the Study:

• To investigate the correlation between initial visual acuity (VA) and facial computed tomographic (CT) findings in patients diagnosed with TON.
• To identify specific CT indicators predictive of poor visual outcomes in TON.

Main Methods:

• Retrospective analysis of facial CT scans from 44 patients with TON.
• Evaluation of CT variables including fractures, hematomas (extraconal, intraconal, along optic nerve), and nerve impingement.
• Comparison of CT findings between patients with and without available VA, with VA converted to logMAR for statistical analysis.

Main Results:

• Intraconal hematoma and optic nerve hematoma were significantly associated with poor visual acuity (p=0.016 and p=0.029, respectively).
• Intraconal hematoma emerged as the strongest predictor of poor VA (coefficient=1.01, p=0.008).
• ROC analysis indicated that intraconal and optic nerve hematomas accurately predicted poor VA (AUC=0.8 and 0.85, respectively).

Conclusions:

• Admission facial CT findings, particularly intraconal and optic nerve hematomas, are valuable in predicting visual outcomes in TON.
• These CT findings can help identify TON patients at higher risk of severe visual impairment, guiding clinical management.