TY - JOUR
A1 - Bhattacharjee, Harsha
A1 - Bhattacharjee, Kasturi
A1 - Jain, Lokesh
A1 - Sarma, Gitumoni
A1 - Sarma, Angshuman
A1 - Medhi, Jnanankar
A1 - Das, Dipankar
A1 - Buragohain, Sanjoy
T1 - Indirect optic nerve injury in two-wheeler riders in northeast India
Y1 - 2008/12/1
JF - Indian Journal of Ophthalmology
JO - Indian J Ophthalmol
SP - 475
EP - 480
VL - 56
IS - 6
UR - https://journals.lww.com/ijo/pages/default.aspx/article.asp?issn=0301-4738;year=2008;volume=56;issue=6;spage=475;epage=480;aulast=Bhattacharjee
DO - 10.4103/0301-4738.43367
N2 - Purpose: To investigate the association of posterior indirect traumatic optic neuropathy and superior temporal orbital rim injury in two-wheeler riders and documentation of the clinical profile of such cases.
Design: Retrospective observational study.
Materials and Methods: Records of all patients reporting with cranio-orbital injury and vision loss following road traffic accidents between October 1994 and April 2006 were reviewed and from them cases with vision loss solely from indirect optic nerve injury were taken up for study. The prognostic significance of different presenting features, role of intravenous methyl prednisolone (IVMP) and relative risk of superior orbital rim injury to posterior indirect traumatic optic neuropathy (at 95% confidence interval) was calculated.
Results: Out of 129 consecutive cases of cranio-orbital injury, 35 had posterior indirect traumatic optic neuropathy with minor ipsilateral superior temporal orbital rim trauma and none used any protective headwear. Presenting clinical features like relative afferent pupillary defect ( P = 0.365), optic disc status ( P = 0.518) and visual evoked potential (VEP) ( P = 0.366) were disproportionate to visual loss. Only VEP had prognostic significance. The IVMP did not provide any added therapeutic benefit. The remaining 94 cases sustained direct blinding ocular trauma and 28 of them had associated intracranial pathology. The relative risk of superior temporal orbital rim injury to posterior indirect optic nerve trauma was 2.25.
Conclusion: Superior temporal orbital rim injury, even when minor, carries a potential risk for development of blindness from indirect posterior indirect traumatic optic neuropathy in two-wheeler drivers. Presenting signs do not correlate with visual status. Only VEP has prognostic significance and the condition is untreatable.
ER -