Early diagnosis and prognosis of traumatic optic neuropathy

Authors

Bilalov E.N.

DSc, Professor, Ophthalmology Department, Tashkent Medical Academy, Uzbekistan
Bahritdinova F.A.

DSc, Professor, Ophthalmology Department, Tashkent Medical Academy, Uzbekistan
Narzikulova K.I.

DSc, Associate Professor, Ophthalmology Department, Tashkent Medical Academy, Uzbekistan
Nazirova S.H.

PhD, Associate Professor, Ophthalmology Department, Tashkent Medical Academy, Uzbekistan
Egamberdieva S.M.

Assistant of Ophthalmology Department, Tashkent Medical Academy, Uzbekistan
Oralov B.A.

PhD, Assistant of Ophthalmology Department, Tashkent Medical Academy, Uzbekistan
Pirnazarov M.Y.

Assistant of Ophthalmology Department, Tashkent Medical Academy, Uzbekistan

DOI:

https://doi.org/10.37547/ijmscr/Volume05Issue01-08

Keywords:

Traumatic optic neuropathy blunt eye trauma optical coherence tomography

Abstract

Traumatic optic neuropathy (TON) caused by blunt eye injuries represents a significant clinical challenge, frequently leading to irreversible vision loss. Early diagnosis and monitoring of retinal and optic nerve changes are crucial for improving patient outcomes. Optical coherence tomography (OCT) offers unparalleled capabilities in detecting and quantitatively assessing such changes.

Objective. To evaluate the diagnostic potential of OCT in identifying morphological and functional changes in the retina and optic nerve among patients with TON.

Materials and Methods. A total of 40 patients with blunt eye trauma were examined. The diagnostic protocol included OCT, computer perimetry, visual acuity testing, and ophthalmoscopy. Parameters of the RNFL, GCIPL, macula, and optic nerve head were analyzed.

Results. Patients with TON demonstrated significant RNFL thickening in the early stages of trauma, optic nerve head swelling, and GCIPL thinning, which correlated with impaired visual function. OCT proved to be highly effective for early diagnosis and monitoring of these changes.

Conclusion. OCT is a pivotal tool for assessing retinal and optic nerve damage in TON, enabling improved diagnostics, prognostication, and patient management.

References

Билалов, Э. Н., et al. "Значение оптической когерентной томографии в диагностике повреждений сетчатки и зрительного нерва." Advanced Ophthalmology 3.3 (2023): 40-45.

Кашников В.В. Контузионные изменения глазного дна. Новосибирск, 2000. 171 с.

Нарзикулова, Кумри Исламовна, et al. "Разработка и оценка эффективности фотодинамической терапии при воспалительных заболеваниях глазной поверхности." Офтальмологические ведомости 13.3 (2020): 55-65.

Bakhritdinova F.A., Mirrakhimova S.S., Narzikulova K.I., Oralov B.A. Dynamics of cytological parameters of the conjunctiva in the course of a complex treatment of eye burns using a low-intensity laser radiation. The EYE Glaz 2019, V 21, (3 (127)), 7-11. https://doi.org/10.33791/2222-4408-2019-3-7-11

Bakhritdinova FA, Bilalov EN, Oralov BA, Mirrakhimova SSh, Safarov ZhO, Oripov OI, Nabieva IF. Assessment of the state of the lacrimal complex in patients with dry eye syndrome during treatment. Russian ophthalmological journal. 2019; 12 (4): 13–18 (In Russ.)

Bakhritdinova, Fazilat A., et al. "Reparative and antioxidant therapy of chemical eye burns." Russian Ophthalmological Journal 14.4 (2021): 31-37.

Bastakis GG, Ktena N, Karagogeos D, Savvaki M. Models and treatments for traumatic optic neuropathy and demyelinating optic neuritis. Dev Neurobiol. 2019 Aug;79(8):819-836. doi: 10.1002/dneu.22710. Epub 2019 Jul 25. PMID: 31297983.

Blanch RJ, Joseph IJ, Cockerham K. Traumatic optic neuropathy management: a systematic review. Eye (Lond). 2024 Aug;38(12):2312-2318. doi: 10.1038/s41433-024-03129-7. Epub 2024 Jun 11. PMID: 38862644; PMCID: PMC11306366.

Chalela JA. Traumatic Optic Neuropathy: The Forgotten Concussion. Mil Med. 2023 Jan 4;188(1-2):398-400. doi: 10.1093/milmed/usac060. PMID: 35302167.

Chen B, Zhang H, Zhai Q, Li H, Wang C, Wang Y. Traumatic optic neuropathy: a review of current studies. Neurosurg Rev. 2022 Jun;45(3):1895-1913. doi: 10.1007/s10143-021-01717-9. Epub 2022 Jan 16. PMID: 35034261.

Kupersmith M.J., Kardon R., Durbin M.K., Shulman J. Scanning laser polarimetry reveals status of СНВС integrity in eyes with optic nerve head swelling by OCT // Investigation Ophthalmological Visus Science. ― 2012. ― Vol. 53. ― P. 1962-1970.

Medeiros F.A., Moura F.C., Vessani R.M. et al. Axonal loss after traumatic optic neuropathy documented by optical coherence tomography // Am. J. Ophthalmol. 2003. V. 135. P. 406-408.

Narzikulova K.I., Bakhritdinova F.A., Mirrakhimova S.S., Oralov B.A. Development and evaluation of the effectiveness of photodynamic therapy in inflammatory diseases of the ocular surface. Ophthalmology journal 13 (3), 2020, 55-65. DOI: https://doi.org/10.17816/OV33828

Steinsapir KD, Goldberg RA. Traumatic optic neuropathy: an evolving understanding. Am J Ophthalmol. 2011 Jun;151(6):928-933.e2. doi: 10.1016/j.ajo.2011.02.007. Epub 2011 May 6. PMID: 21529765.