Research Article Volume 7 • Issue 3 36 Visual Outcome after Systemic Steroid Therapy in Traumatic Optic Neuropathy Rodela Saha 1* , Pritam Roy 2 , Aminur Rahman 3 , Mujtahid Mohammad Hossain 4 , Tarzia Asma Zafrullah 5 , A K M Shahidur Rahman 6 Affiliation: 1 Assistant Professor, Lions Eye Hospital and Institute, Dhaka, Bangladesh 2 Resident (Plastic Surgery), Sheikh Hasina National Institute of Burn and Plastic Surgery,, Dhaka, Bangladesh 3 Assistant Registrar, National Institute of Ophthalmology and Hospital (NIO&H), Dhaka, Bangladesh 4 Director (Human Resource Management), Directorate General of Medical Education, Dhaka, Bangladesh 5 Assistant Professor, Lions Eye Hospital and Institute, Dhaka, Bangladesh 6 Medical Officer, Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh *Corresponding author: Dr. Rodela Saha, Assistant Professor, Lions Eye Hospital and Institute, Dhaka, Bangladesh. Email: rodelasaha2016@gmail.com Citation: Saha R, Roy P, Rahman A, Hossain MM, Zafrullah TA, Rahman AKMS. Visual Outcome after Systemic Steroid Therapy in Traumatic Optic Neuropathy. Journal of Ophthalmology and Research. 7 (2024): 36-41. Received: July 18, 2024 Accepted: July 29, 2024 Published: August 16, 2024 Abstract Background: Traumatic optic neuropathy (TON) is an acute injury of the optic nerve due to trauma. It is an ocular emergency that demanding early treatment. Systemic steroids and surgical decompression are the recommended treatment. Objective: To assess the visual outcomes after systemic steroid therapy among patients with TON. Methods: This prospective observational study was conducted at Department of Neuro-ophthalmology, National Institute of Ophthalmology and Hospital (NIO&H), Dhaka, Bangladesh, from December 2019 to February 2022, on 48 eyes of 48 patients with TON. Patients were selected on selection criteria; they underwent detail ocular examination as well as relevant investigations. Methylprednisolone 1 gram was given intra- venously for 5 days followed by oral prednisolone tablet 1 mg/kg body weight daily in tapering dose for 2 weeks. They were followed up on 1 week, 1 month and 3 months after starting treatment. Best corrected visual acuity (BCVA) in log MAR unit, color vision by Ishihara pseudoisochromatic chart and relative afferent pupillary defect (RAPD) grades were assessed in each follow up. Morphology of the disc was assessed prior to starting treatment and at final follow up. Results: The mean(±SD) base-line BCVA was 0.99±0.22 Log MAR unit, it was 0.89±0.30, 0.69±0.37 and 0.39±0.37 after 1 week, 1 month and 3 months respectively. The mean base-line value of color vision was 1.48±2.27, it was 8.98±3.65, 18.15±7.00 and 23.02±8.66 after 1 week, 1 month and 3 months respectively. We found a significant improvement in RAPD grading at final follow up (p <0.001). Pallor of the disc was found among 20 patients at final follow-up (<0.001). Conclusion: Visual status of patients with traumatic optic neuropathy improves by systemic steroid therapy. It is evident by significant improvement of visual acuity, color vision and RAPD grading. Keywords: Ocular Examination; Systemic Steroid Therapy; Traumatic Optic Neuropathy (TON); Visual Outcome Introuduction Traumatic optic neuropathy (TON) is an acute injury of the optic nerve secondary to ocular or head injury, characterized by severe irreversible vision loss with relative afferent pupillary defect (RAPD), color vision defect and visual field loss [1-2]. The severity of optic nerve damage may range from simple contusion to comprehensive disinsertion of the nerve fibers from the globe at the level of the lamina cribrosa [3-4]. More recent