To the Editor.
—I read with interest the article by Joseph et al1 in the August 1990 issue of the Archives. I was impressed with their surgical results. I have used a surgical technique similar to theirs but have not had as much success in the patients I selected for such intervention.Although the article reports therapeutic success in what is often a difficult disease to treat, I am concerned about some of the conclusions drawn by the authors. A major problem with the series is that all of the patients operated on received corticosteroid therapy. The recent retrospective study from San Francisco suggests a beneficial effect of high-dose corticosteroids in these patients.2 In the San Francisco study, 13 (62%) of 21 patients treated with steroids had visual improvement. This compares favorably with the 11 (78.6%) of 14 patients treated with steroids and undergoing surgery in the report
Seiff SR. Therapy for Traumatic Optic Neuropathy. Arch Ophthalmol. 1991;109(5):610. doi:10.1001/archopht.1991.01080050016001