A CT radiomics nomogram predicts visual acuity improvement in patients with indirect traumatic optic neuropathy following optic canal decompression
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By
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Guangyu Wang
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Pengran Yu
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Shuo Li
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Wenchuan Zhang
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May 18, 2026
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Clinical Scorecard: A CT Radiomics-Based Nomogram for Forecasting Visual Acuity Enhancement in Indirect Traumatic Optic Neuropathy Patients After Optic Canal Decompression
At a Glance
| Category | Detail |
|---|
| Condition | Indirect Traumatic Optic Neuropathy (ITON) |
| Key Mechanisms | Axonal edema, microvascular compromise, retinal ganglion cell apoptosis |
| Target Population | Patients with ITON undergoing optic canal decompression |
| Care Setting | Retrospective, single-center study |
Key Highlights
- Developed a nomogram incorporating radiomics and clinical predictors for VA improvement post-OCD
- Demonstrated AUC values of 0.840 in training and 0.832 in test sets
- Significantly higher VA improvement rates in low-risk vs high-risk groups
- Validated through calibration curves and decision curve analysis
- Potential to inform personalized treatment strategies
Guideline-Based Recommendations
Diagnosis
- Diagnosis based on history of craniofacial trauma, observed visual impairment, and relative afferent pupillary defect
Management
- Optic canal decompression (OCD) as primary surgical intervention
Monitoring & Follow-up
- Postoperative follow-up for a minimum of 3 months to evaluate visual acuity
Risks
- Approximately 50% of patients may experience irreversible visual acuity impairment
Patient & Prescribing Data
169 patients with ITON who underwent OCD
OCD can be performed via various surgical approaches tailored to individual cases
Clinical Best Practices
- Utilize the developed nomogram for preoperative risk stratification
- Consider patient-specific factors such as initial VA and optic canal fractures
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