Retinal vasculature in indirect traumatic optic neuropathy with endoscopic optic canal decompression

To quantify alteration of retinal peripapillary microvasculature and visual function within three months follow-up in indirect traumatic optic neuropathy (ITON) after endoscopic trans-ethmosphenoid optic canal decompression (ETOCD).

Thirty-seven ITON eyes were included. Radial peripapillary capillary (RPC) density at pre-operation and post-operation within three months follow-up (pre-op, post-op 2 weeks, post-op 1 month and post-op 3 months) was analyzed. The comparisons of RPC density and best corrected visual acuity (BCVA) at different points were analyzed.

In ITON eyes, preoperative global RPC density was reduced compared to unaffected eyes (P ≤ 0.001). Global RPC density of ITON at pre-op, post-op 2 weeks, 1 month and 3 months were 47.71 ± 7.36, 40.56 ± 8.71, 40.75 ± 7.06 and 33.95 ± 8.03, respectively. For ITON eyes, three points' post-op global RPC density significantly differed from pre-op RPC density (All P ≤ 0.006). BCVA of ITON at pre-op, post-op 2 weeks, 1 month and 3 months were 2.41 ± 1.61, 1.84 ± 1.43, 1.54 ± 1.39 and 1.54 ± 1.38, respectively. A significant difference had been found at post-op 1 month and post-op 3 months when compared to pre-op BCVA (P = 0.018 and 0.015, respectively).

The reduced RPC density occurred in ITON with a plateau between post-op 2 weeks and post-op 1 month. The visual improvement might be secondary to the alteration of retinal perfusion after ETOCD for a long time, though discrepancies in structural-functional resilience existed.