Abstract
BACKGROUND: To quantify alteration of retinal peripapillary microvasculature and visual function within three months follow-up in indirect traumatic optic neuropathy (ITON) after endoscopic trans-ethmosphenoid optic canal decompression (ETOCD). METHODOLOGY: Thirty-seven ITON eyes were included. Radial peripapillary capillary (RPC) density at pre-operation and post-operation within three months follow-up (pre-op, post-op 2 weeks, post-op 1 month and post-op 3 months) was analyzed. The comparisons of RPC density and best corrected visual acuity (BCVA) at different points were analyzed. RESULTS: In ITON eyes, preoperative global RPC density was reduced compared to unaffected eyes (P ≤ 0.001). Global RPC density of ITON at pre-op, post-op 2 weeks, 1 month and 3 months were 47.71 ± 7.36, 40.56 ± 8.71, 40.75 ± 7.06 and 33.95 ± 8.03, respectively. For ITON eyes, three points' post-op global RPC density significantly differed from pre-op RPC density (All P ≤ 0.006). BCVA of ITON at pre-op, post-op 2 weeks, 1 month and 3 months were 2.41 ± 1.61, 1.84 ± 1.43, 1.54 ± 1.39 and 1.54 ± 1.38, respectively. A significant difference had been found at post-op 1 month and post-op 3 months when compared to pre-op BCVA (P = 0.018 and 0.015, respectively). CONCLUSIONS: The reduced RPC density occurred in ITON with a plateau between post-op 2 weeks and post-op 1 month. The visual improvement might be secondary to the alteration of retinal perfusion after ETOCD for a long time, though discrepancies in structural-functional resilience existed.