ObjectiveTo investigate the clinical characteristics and prognostic factors of traumatic optic neuropathy (TON) treated by imageguided optic decompression.MethodsThe clinical data of 20 patients with TON admitted to the Second Hospital of Shanxi Medical University from January 2015 to December 2018 were analyzed retrospectively.Univariate and nonconditional Logisitic regression analyses were used to evaluate the effects of different factors on TON treatment.ResultsPostoperative followup was conducted for 3 months to 1 years, and the total effective rate was 60.0% (12/20), among which the effective rate was 100.0% (6/6) for those with preoperative light perception, and 42.9% (6/14) for those without preoperative light perception.The effective rate was 75% (9/12) for who underwent surgery within 1 week of injury. Preoperative CT showed that the effective rate was 22.2% (2/9) in patients with optic canal fracture. Univariate and multivariate results were shown: preoperative visual acuity and CT showed optic canal fracture are the influencing factors of surgical prognosis of patients.ConclusionsNasal endoscopic optic nerve decompression is an effective method for treatment of traumatic visual mental derangement. Preoperative light perception and reserved visual acuity are protective factors for visual acuity improvement, while preoperative CT scan revealed a fracture of the optic canal is a risk factor.For patients with complex facial trauma, the application of image navigation can achieve the purpose of precise positioning and effective decompression. It is worthy of promotion for improve the surgical efficacy of the patients.