Patterns and Prognosis of Visual Field Changes in Patients with Traumatic Optic Neuropathy
Author: Hee-young Choi
Base Hospital / Institution: Pusan National University Hospital/Pusan National University, School of Medicine
ePoster presentation
Abstract ID: 24-140
Purpose
To analyze visual field patterns in traumatic optic neuropathy(TON) patients and investigate factors related to the prognosis of visual acuity and visual field.
Methods
The authors conducted a retrospective analysis of medical records from 54 patients diagnosed with TON between 2014 and 2023. Various factors, including gender, age, trauma mechanism and timing, treatment methods, visual acuity, visual field, and intracranial hemorrhage, were examined. The study classified visual field patterns based on 17 mutually exclusive patterns from OHTS investigated related factors.
Results
Of the 54 patients, 43 (79.6%) were male, and head trauma (42.3%) and falls (22.2%) were the most common locations and causes, respectively. Intracranial hemorrhage was present in 61.1% of patients. The most common initial visual field defects were total loss (63.0%) and altitudinal loss (25.9%). During the final visual field test, similar patterns of total and altitudinal losses were observed. 59.3% of patients received steroid treatment, and among all patients, those who received high-dose steroids treatment within 24 hours had a final visual acuity of 0.1 or more more than those who did not (OR=4.286, p=0.017). An initial visual field index(VFI) was associated with a final visual acuity of 0.1 or more (32.1%) (OR=1.06, p=0.032). Cases where final VFI maintaining over 80% of the initial VFI were linked to early high-dose steroid treatment (OR=5.00, p=0.039). However, the visual field pattern had no relationship with the final visual acuity or VFI improvement.
Conclusion
TON commonly resulted in altitudinal visual field defects and total loss. However, existing classification criteria for visual field defects had limited applicability. Factors influencing visual acuity and visual field prognosis included the initial VFI and administration of high-dose steroids treatment within 24 hours. The study highlights the importance of evaluating initial visual field test and promptly administering high-dose steroids in patients with TON.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Jun | Heo | Pusan National University Hospital/Pusan National University, School of Medicine |
| Jung Jul | Park | Pusan National University Hospital/Pusan National University, School of Medicine |
