Wolin M J, Lavin P J
Department of Ophthalmology, Vanderbilt University Medical Center, Nashville, Tennessee.
Am J Ophthalmol. 1990 Apr 15;109(4):430-5. doi: 10.1016/s0002-9394(14)74609-4.
Four patients who developed immediate blindness (no light perception) after indirect traumatic optic neuropathy caused by blunt head injury recovered vision without surgical intervention. In one patient, whose affected eye recovered to a visual acuity of 20/50 + 2, corticosteroids were not used. In two of the other patients, visual recovery began before corticosteroids were instituted. One patient recovered a visual acuity of R.E.: 20/15, one recovered a visual acuity of L.E.: 20/25-2, and one recovered a visual acuity of R.E.: 20/200 but with useful temporal field vision. Many investigators advocate aggressive surgical therapy for indirect neuropathy, particularly when corticosteroids fail. Significant recovery may occur despite no light perception, however, with medical therapy or even without therapy.
4例因钝性头部损伤导致间接性外伤性视神经病变后立即失明（无光感）的患者在未进行手术干预的情况下恢复了视力。其中1例患眼恢复至视力20/50 + 2的患者未使用皮质类固醇。另外2例患者在开始使用皮质类固醇之前视力就已开始恢复。1例患者右眼视力恢复至20/15，1例患者左眼视力恢复至20/25 - 2，1例患者右眼视力恢复至20/200，但颞侧视野有用。许多研究者主张对间接性神经病变采取积极的手术治疗，尤其是在皮质类固醇治疗无效时。然而，即使无光感，通过药物治疗甚至不进行治疗，也可能出现显著恢复。
