Purchase this article with an account.
N. P. Katsoulakis, T. Filippopoulos, S. K. Rao, N. Desai, M. E. Migliori; Traumatic Optic Neuropathy in Motorcycle Accidents. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2483.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To determine if helmets were associated with a decreased incidence of TON and better visual outcomes.
A retrospective chart review of all consultations to the department of Ophthalmology at Rhode Island Hospital (RIH) (level 1 trauma center) for patients involved in MCAs presenting between 1997 and 2005 was performed. At RIH a protocol has been implemented requiring an ophthalmologic evaluation to all patients with orbital fractures or head trauma requiring intubation, within 24 hours of presentation. However, there is no uniform treatment protocol for TON. Visual acuity, type of ocular injury, number and location of orbital fractures, helmet status, intubation status, blood alcohol level on arrival, length of hospital stay and length of follow up were reviewed and analyzed.
N=62 patients were identified. Five patients were excluded from further analysis due to unknown helmet status at time of injury. 39/57 patients (68%) were not wearing a helmet at time of injury. Average age at presentation ± SD was 35.7 ± 10.1 years (range 16-57). 85% of patients were males. 51.6% of patients were legally intoxicated at time of injury (BAC >80 mg/dl). 5/62 (8%) patients suffered TON. The final visual acuity of patients with TON ranged from 20/30 to NLP after a median follow-up of 60 days. Three out of five TON patients were treated with steroids. 4/5 (80%) patients with TON were not wearing a helmet (chi-square= 1.98 for the proportions of patients with TON with or without helmet). 4/5 (80%) of patients with TON had ipsilateral orbital fractures.
There is a low (8%) but not insignificant incidence of TON after MCAs especially in patients not wearing helmets. Those patients suffer severe visual loss; a careful pupillary exam of the intubated head trauma victim is therefore imperative. Our study failed to reach statistical significance due to the low incidence of TON.
This PDF is available to Subscribers Only