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However, the optimal management strategy remains controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis aimed to compare the efficacy and safety of surgical optic canal decompression versus corticosteroid therapy in patients with TON.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library for studies published between January 2005 and July 2025. Both randomized controlled trials and observational studies reporting visual or structural outcomes were included. Data were pooled using a random\u2010effects model, and subgroup analyses were performed according to intervention timing, type of injury, and baseline severity. Risk of bias was assessed with RoB 2.0 and the Newcastle\u2013Ottawa Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010four studies involving 1046 patients were included. Surgical decompression significantly improved visual outcomes compared with corticosteroids (62% vs. 37%; OR\u2009=\u20092.35, 95% CI: 1.55\u20133.56). Subgroup analyses indicated superior outcomes with early surgery (\u2264\u20097\u2009days; OR\u2009=\u20092.91, 95% CI: 1.74\u20134.88) and in indirect TON (OR\u2009=\u20092.62, 95% CI: 1.70\u20134.04), whereas benefits were less pronounced in direct injuries. Structural outcomes also favored surgery, with greater retinal nerve fiber layer preservation (mean difference\u2009=\u2009+9.4\u2009\u03bcm) and lower incidence of optic atrophy (OR\u2009=\u20090.44, 95% CI: 0.27\u20130.71). Adverse events were mild and comparable between groups. Funnel plot analysis revealed no significant asymmetry, suggesting minimal publication bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis provides indicative evidence that early surgical decompression may offer superior outcomes compared with corticosteroid therapy, especially for indirect injuries. Specifically, this meta\u2010analysis suggests that surgical intervention may offer superior outcomes without increasing adverse events. Nevertheless, the evidence base remains limited, and these results should be interpreted with caution. While corticosteroids alone show limited benefit and may be considered adjunctive when surgery is not feasible, high\u2010quality multicenter randomized trials are urgently needed to standardize treatment protocols and optimize patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70454","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T11:37:26Z","timestamp":1767094646000},"page":"1063-1072","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Traumatic Optic Neuropathy After Head Trauma: Pathophysiology, Interventions, and Evidence From Meta\u2010Analysis"],"prefix":"10.1111","volume":"96","author":[{"given":"Cui","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Chongqing Emergency Medical Center, Chongqing University Central Hospital  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Chongqing Emergency Medical Center, Chongqing University Central Hospital  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaosu","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Chongqing Emergency Medical Center, Chongqing University Central Hospital  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7575-3137","authenticated-orcid":false,"given":"Shu","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Chongqing Emergency Medical Center, Chongqing University Central Hospital  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.20471\/acc.2018.57.01.22"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.13004\/kjnt.2018.14.1.1"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-021-01717-9"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1556147"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291715001981"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e31824cd4a7"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/20523211.2024.2322107"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40258-013-0060-y"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNO.0b013e31821c9b11"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2023.101939"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/prp2.472"},{"issue":"4","key":"e_1_2_9_13_1","first-page":"183","article-title":"Global Progress Against Cancer\u2010Challenges and Opportunities","volume":"10","author":"Biemar F.","year":"2013","journal-title":"Cancer Biology & Medicine"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.00282"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/5553885"},{"issue":"9","key":"e_1_2_9_16_1","article-title":"A Rare Presentation of Direct Traumatic Optic Neuropathy in a Patient Poked in the Eye by an Antenna","volume":"13","author":"Tenewitz J. 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