Goldenberg-Cohen Nitza, Miller Neil R, Repka Michael X
Johns Hopkins University School of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287-9028, USA.
J AAPOS. 2004 Feb;8(1):20-7. doi: 10.1016/j.jaapos.2003.08.009.
Retrospective review to describe the features and visual outcome of traumatic optic neuropathy (TON) in children and adolescents.
Interventional and observational case series of children <18 years with TON.
Forty children, 24 boys and 16 girls, were identified with 43 affected eyes. The mean age was 11.6 years (range, 2 to 18). The most common causes were motor vehicle accidents (62%) and sports injuries (22%). The trauma was blunt in 78% of cases and penetrating in 22%. Visual acuity at presentation for 27 patients whose visual acuity could be assessed ranged from no light perception to 20/80. Interventions included corticosteroids (n = 18), decompression of the optic canal (n = 3), and optic sheath nerve fenestration (n = 1). Visual outcome for 22 children with at least 1 month of follow-up was no light perception in 10 (45%), < 20/200 in 7(32%), 20/200 to < 20/80 in 1(4%), and > or = 20/80 in 4 (18%). There was no difference in the rate or degree of improvement between treated and untreated patients.
TON in children is caused by mechanisms similar to those that cause TON in adults. The severity of visual loss as well as the rate and degree of improvement are also similar. Our data do not indicate that treatment improves visual outcome.
进行回顾性研究以描述儿童和青少年创伤性视神经病变（TON）的特征和视觉预后。
对18岁以下患有TON的儿童进行干预性和观察性病例系列研究。
共确定40名儿童，其中24名男孩和16名女孩，43只眼睛受累。平均年龄为11.6岁（范围2至18岁）。最常见的病因是机动车事故（62%）和运动损伤（22%）。78%的病例为钝挫伤，22%为穿通伤。27名视力可评估的患者就诊时视力范围从无光感到20/80。干预措施包括使用皮质类固醇（n = 18）、视神经管减压（n = 3）和视神经鞘膜开窗术（n = 1）。22名至少随访1个月的儿童的视觉预后为：10名（45%）无光感，7名（32%）视力<20/200，1名（4%）视力在20/200至<20/80之间，4名（18%）视力≥20/80。治疗组和未治疗组患者的改善率和改善程度无差异。
儿童TON的病因机制与成人TON相似。视力丧失的严重程度以及改善率和改善程度也相似。我们的数据表明治疗并不能改善视觉预后。
