Neuropathies optiques post-traumatiques : à propos de 8 cas et revue de la littérature

Although underestimated, visual involvement is among the most frequent neurological complications of head trauma. There is no consensus in the management of these patients and visual recovery is uncertain. The goal of our study is to describe the clinical presentation and the clinical course of traumatic optic neuropathy in patients with head or maxillo-facial trauma. The clinical records of 8 patients, treated from November 2007 to March 2012, were reviewed in the department of ophthalmology (visual testing) of the university regional medical center in Lille. The most frequent cause of injury was traffic accidents. Unilateral optic neuropathy was observed in 6 cases, and bilateral in two cases, for a total of 10 eyes. Eight presented a significant visual loss < 6/12. Improvement of visual acuity was achieved in 5 cases to 9/10 distance acuity without any medical or surgical treatment. One patient required surgical decompression, without improvement of visual acuity, and with persistent oculomotor disturbance and unreactive mydriasis. Traumatic optic neuropathy can cause profound visual acuity loss, especially if it is already significantly decreased on presentation.