Comparison of Surgical Decompression and Steroid Therapy for the Management of Traumatic Optic Neuropathy: A Systematic Review and Meta-Analysis
Abstract
:Introduction
- (1)
- Type and indication of intervention.
- (2)
- Timing of intervention. Assessment of posttreatment status.
- (3)
- RCT trials available and their strength.
Materials and Methods
Literature Search Strategy
Study Eligibility
Data Extraction Process
Critical Appraisal of Included Studies
Summary Measures and Synthesis of Results
Results
Result of Search Strategy (Study Selection)
Improvement in Visual Acuity
- (i)
- One line improvement in SC.
- (ii)
- Two-line improvement in SC.
- (iii)
- Three-line improvement in SC.
- (iv)
- Log MAR values from SC.
- (v)
- Landolt’s ring assessment (LR).
- (vi)
- Percentage improvement in Log MAR values.
Discussion
Steroid-Mechanism of Action and the Safe Dose
Surgical Decompression Protocols and Techniques
Evolution of Surgical Decompression Techniques
Optic Canal Fracture and Treatment Protocol
Indications for Surgical Decompression
- (I)
- 72 hours of steroid without improvement.
- (II)
- Progressive visual loss.
- (III)
- Total blindness with evidence of optic nerve compression on computed tomography.
Criteria for Assessment of Visual Acuity Improvement
Limitations of Study and Scope of Improvements for Further Research
Conclusion
Author Contributions
Funding
Declaration of Conflicting Interests
Abbreviation
TON | traumatic optic neuropathy |
VA | visual acuity |
NLP | no light perception |
LP | light perception |
HM | hand movement |
FC | finger counting |
SC | Snellen chart |
Log MAR | Log minimum angle of resolution. |
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© 2022 by the authors. Published by MDPI on behalf of the AO Foundation. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Pandey, S.; Reddy, G.S.; Chug, A.; Dixit, A.; Raja, B.S. Comparison of Surgical Decompression and Steroid Therapy for the Management of Traumatic Optic Neuropathy: A Systematic Review and Meta-Analysis. Craniomaxillofac. Trauma Reconstr. 2023, 16, 306-316. https://doi.org/10.1177/19433875221142682
Pandey S, Reddy GS, Chug A, Dixit A, Raja BS. Comparison of Surgical Decompression and Steroid Therapy for the Management of Traumatic Optic Neuropathy: A Systematic Review and Meta-Analysis. Craniomaxillofacial Trauma & Reconstruction. 2023; 16(4):306-316. https://doi.org/10.1177/19433875221142682
Chicago/Turabian StylePandey, Sameer, Gosla S. Reddy, Ashi Chug, Ashutosh Dixit, and Balgovind S. Raja. 2023. "Comparison of Surgical Decompression and Steroid Therapy for the Management of Traumatic Optic Neuropathy: A Systematic Review and Meta-Analysis" Craniomaxillofacial Trauma & Reconstruction 16, no. 4: 306-316. https://doi.org/10.1177/19433875221142682
APA StylePandey, S., Reddy, G. S., Chug, A., Dixit, A., & Raja, B. S. (2023). Comparison of Surgical Decompression and Steroid Therapy for the Management of Traumatic Optic Neuropathy: A Systematic Review and Meta-Analysis. Craniomaxillofacial Trauma & Reconstruction, 16(4), 306-316. https://doi.org/10.1177/19433875221142682