Acute Neuroimaging Findings in Traumatic Optic Neuropathy

Recently, a small retrospective series demonstrated that diffusion-weighted imaging modalities can be used to calculate an apparent diffusion coefficient for the optic nerve that acts as a specific imaging marker for TON and furthermore corresponds with severity of vision loss.3 Another group has pr...

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Bibliographic Details
Published in:Canadian journal of neurological sciences 2023-11, Vol.50 (6), p.937-938
Main Authors: Trask, William M., Mak, Michael Y.K., Gohill, Jitendra, Kherani, Amin, Subramaniam, Suresh
Format: Article
Language:English
Subjects:
Edema
Head injuries
Letter to the Editor: New Observation
Magnetic resonance imaging
Medical imaging
Neuroimaging
Optic nerve
Steroids
Trauma
Traumatic brain injury
Visual acuity
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Summary:Recently, a small retrospective series demonstrated that diffusion-weighted imaging modalities can be used to calculate an apparent diffusion coefficient for the optic nerve that acts as a specific imaging marker for TON and furthermore corresponds with severity of vision loss.3 Another group has proposed that diffusion tensor imaging parameters in the acute setting following ITON may correlate with visual outcome measures such as retinal nerve fiber layer thickness and retinal ganglion cell count.4 No treatment for indirect TON has been shown to be effective, and observational studies of indirect TON demonstrate wide variability of recovery, time course, and end-point visual function. The only two large-scale randomized studies examining high-dose IV corticosteroids in indirect TON have failed to identify a benefit in visual outcome over observation.5,6 Moreover, the MRC CRASH study concluded high-dose corticosteroids should not be routinely offered to patients suffering a traumatic head injury due to an elevated risk of death or severe disability.7 Levodopa is thought to have possible neuroprotective effects, and some authors have reported a beneficial effect thereof,8 but this has never been explored in a large-scale, randomized controlled fashion. Dr. William M. Trask MD BSc, Section of Ophthalmology, University of Calgary Cumming School of Medicine, Rockyview General Hospital Eye Clinic, 4th Floor Fisher Building, 7007 14 Street SW, Calgary, Alberta T2V 1P9, Canada.
ISSN:0317-1671
2057-0155
DOI:10.1017/cjn.2022.308