You are here

Article Text

Article menu

Download PDFPDF

Clinical science
Incidence of optic canal fracture in the traumatic optic neuropathy and its effect on the visual outcome
Free
  1. Wentao Yan2,
  2. Yingbai Chen3,
  3. Zhenbin Qian2,
  4. Dinesh Selva4,
  5. Daniel Pelaez5,
  6. Yunhai Tu2,
  7. Wencan Wu1
  1. 1Department of Orbital and Oculoplastic Surgery, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China
  2. 2Department of Orbital and Oculoplastic Surgery, Eye Hospital of Wenzhou Medical University, Wenzhou, PR China
  3. 3Department of Ophthalmology, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
  4. 4Discipline of Ophthalmology and Visual Sciences, University of Adelaide and South Australian Institute of Ophthalmology, Adelaide, Australia
  5. 5Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
  1. Correspondence to Professor Wencan Wu, Department of Orbital and Oculoplastic Surgery, Eye Hospital of Wenzhou Medical University, No. 270 Xueyuan Xi Road, Wenzhou, Zhejiang 325027, P. R. China; wuwencan118{at}163.com

Abstract

Objective To correlate the intraoperative endoscopic findings with high-resolution CT (HRCT) for the diagnosis of optic canal fractures (OCF). To compare the visual outcome of patients with different types of OCF and without.

Design A retrospective, comparative case series.

Participants 1275 consecutive patients (1275 eyes) with indirect traumatic optic neuropathy (TON).

Methods Altogether, 1275 patients who underwent endoscopic transethmoid optic canal decompression (ETOCD) for unilateral indirect TON were reviewed from 1 October 2006 to 30 September 2014. HRCT performed prior to surgery were compared with findings during surgery. The visual outcomes before and after surgery were also compared.

Main outcome measures The presence and type of OCF detected by HRCT and during surgery; visual acuity prior to surgery and at 3 months after surgery.

Results A total of 1275 patients (1275 eyes) were included, with 708 patients that had OCF visible on HRCT image. During surgery, an additional 187 (20.9%) patients with OCF were noticed. Among these, 136 had undisplaced fractures, most of which were linear intracanalicular fractures. The initial visual acuity of patients with OCF was worse than that of patients without OCF (p<0.01). However, no statistical difference existed in the final visual acuity at 3 months after surgery (>0.05). Significant statistical difference of surgical efficacy existed between all the patients with OCF and without OCF (p<0.001).

Conclusions Among patients with OCF, 20.9% were not detected by HRCT. Patients with OCF had a worse initial visual acuity than those without OCF. There was no significant difference in final visual acuity after ETOCD.

https://doi.org/10.1136/bjophthalmol-2015-308043

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • WY and YC are co-first authors and contributed equally.

    • Contributors WW: design, analysis, writing and final approval; WY: design, data collection, writing the paper, analysis of data and final approval; YC: design, analysis, writing the paper, revising the paper and final approval. ZQ: design, analysis, drafting and final approval; DS: data collection, writing and final approval; PSC: analysis, writing and final approval; PD: analysis, writing and final approval; YT: image interpretation and final approval.

    • Funding This study was supported by the Natural Science Foundation of China (81371028), Natural Science Foundation of Zhejiang Province, PR China (LY12H12006) and the Guided Innovation Project of the Eye Hospital of Wenzhou Medical University (YNCX201104).

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The tenets of the Declaration of Helsinki were observed for this retrospective comparative case series, and the study was approved by the eight hospitals’ ethics committees, which include the Eye Hospital of Wenzhou Medical University, the Central Hospital of Lishui, the Central Hospital of Jinhua, Lihuili Hospital in Ningbo, Quzhou People's Hospital in Zhjiang province, Xiamen Eye Hospital in Fujian province, The Fourth Hospital of Shengyang in Liaoning province, and The Second People's Hospital of Zhengzhou city in Henan province.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    Linked Articles

    • At a glance
      Highlights from this issue
      Keith Barton James Chodosh Jost Jonas
      British Journal of Ophthalmology 2017; 101 1-1 Published Online First: 22 Feb 2017. doi: 10.1136/bjophthalmol-2017-310301