Актуальные вопросы хирургической стоматологии и дентальной имплантологии
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Литература:
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одонтогенным остеомиелитом челюстей у детей и взрослых. //Журнал Стоматологии и
краниофациальных исследований №1 (01) 2020 С. 55–59
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CONTROVERSY IN NEURO-OPHTHALMOLOGY STEROID THERAPY FOR
TRAUMATIC OPTIC NEUROPATHY
Mirbabayeva F.A., Hikmatov M.N.
Tashkent state dental institute
Traumatic optic neuropathy (TON) is an uncommon but devastating cause of permanent
visual loss following blunt force trauma to the orbit. Clinically, a patient with acute TON may
present with either partial or complete loss of vision, an afferent pupillary defect, normal-
appearing optic disc, or visual field defects. With time, optic disc pallor will manifest.
Likelihood of vision recovery is low in these patients, as visual acuity and visual field results do
not show significant difference 5 years after injury when compared to baseline testing following
injury.There is an increase in the incidence of traumatic optic neuropathy (TON) due to
increasing urbanization and rapid spurt in the number ofmotor vehicles on the road. Despite early
presentation and ease of diagnosis the visual outcomes in TON are still limited. There is also
significant confusion about the timing, dose and efficacy of steroid treatment in its management.
Purpose:
To provide a clinical update of the pros and cons of steroid therapy for TON.
Design:
The paper is a retrospective review of the currently available literature in the
English language indexed in PubMed.
Methods:
A PubMed search was conducted by the authors using the following terms:
Traumatic optic neuropathy, megadose, steroids, methylprednisolone. Relevant original articles,
review articles, and case reports related to the topic of discussion were evaluated and discussed
in the paper.
Results:
There is no prospective randomized control trial evaluating the effect of steroids
in TON. There are varying reports on the effect of steroid therapy from significant improvement
to no difference compared to observation.
Conclusion:
The decision to give steroids to patients with TON has to be on an individual
case to case basis and must involve informed consent from the patient. There are documented
advantages and disadvantages of steroid therapy and a prospective, randomized, controlled trial
is necessary comparing steroids, surgery and observation before definitive management can be
evolved. cases and a normal fundus in the early posttraumatic period, the diagnosis can be made
with relative ease. There may be associated injury to the orbital/facial bones but severe signs of
blunt trauma to the eye are uncommon often only sign of injury being subconjuctival
hemorrhage. It is most commonly seen in young adult males in the setting of a road traffic
accident or an alleged assault. However, it is the management that is controversial. In this
manuscript, we examine the factors that make therapeutic decision making in TON so difficult
and focus on the controversies regarding use of steroids for treatment.
