Targeted shortwave diathermy combined with perceptual training for patients with severe traumatic optic neuropathy

BackgroundPatients with severe traumatic optic neuropathy (TON) often show limited improvement in visual function despite therapy.ObjectiveThis study aims to investigate whether targeted shortwave diathermy (SWD) combined with perceptual training enhances visual function in patients with severe TON following endoscopic optic nerve decompression (EOND) surgery.MethodsForty patients with severe TON after EOND surgery were randomly assigned to either the rehabilitation (Reh) group (n = 24) or the non-rehabilitation (Nreh) group (n = 16). Subjects in the Reh group received targeted SWD therapy and perceptual training. Visual function, visual evoked potentials, and diffusion tensor imaging were evaluated.ResultsAfter 16 weeks of rehabilitation, the best-corrected visual acuity (p = 0.006) and color vision scores (p = 0.026) in the Reh group improved significantly more than those in the Nreh group. Two children who had completely lost their visual acuity 62 and 73 days after experiencing TON regained visual acuity scores of 1.0 logMAR or lower after rehabilitation. After 10 weeks of rehabilitation, the mean P100 amplitude (p = 0.012) and fractional anisotropy (anterior segment, p = 0.032; middle segment, p = 0.014) of the affected nerves in the Reh group were significantly higher than those in the Nreh group.ConclusionsTargeted SWD combined with perceptual training demonstrated beneficial effects in patients with severe TON after EOND surgery. Notably, this study provides the first evidence of visual function recovery occurring 73 days after complete vision loss in child with TON when combined rehabilitation was implemented.