Abstract: Objective To evaluate the efficacy of erythropoietin (EPO) in the treatment of traumatic optic neuropathy (TON). Design A single-center, non-randomized, concurrent controlled study. Participants 85 TON patients (95 eyes) hospitalized in the Department of Ophthalmology at PLA General Hospital between January 2019 and January 2024. Methods Patients were divided into an EPO treatment group (45 cases, 50 eyes) and a control group (40 cases, 45 eyes) based on their consent to receive EPO therapy. All patients received neurotrophic and microcirculation-improving treatments. The EPO group received intravenous EPO for three consecutive days, while the control group did not undergo this or additional therapies. Follow-ups were conducted at 3 months and ≥12 months post-treatment. Demographic characteristics, clinical data, and best-corrected visual acuity (BCVA) before and after treatment were collected. Visual prognosis was compared between groups, and influencing factors (treatment modality, age, sex, light perception, time to vision loss, history of coma, abnormal FVEP, presence of sphenoid/ethmoid sinus hemorrhage, orbital fractures/hematoma, optic canal fractures, history of optic canal decompression, and glucocorticoid therapy) were analyzed via univariate and multivariate analyses. Adverse effects of EPO were recorded. Visual improvement was defined as a BCVA decline of ≥0.3 LogMAR at follow-up. Main Outcome Measures BCVA before and after treatment, factors influencing efficacy, and adverse reactions. Results At 3 months post-treatment, 26 eyes (52.0%) in the EPO group showed visual improvement, significantly higher than 13 eyes (28.9%) in the control group (χ2=5.228, P=0.022). At ≥12 months post-treatment, 28 eyes (56.0%) in the EPO group demonstrated improvement, while the control group showed no changes, with a statistically significant difference (χ2=7.096, P=0.008). Five eyes in the EPO group exhibited continued BCVA improvement at ≥12 months, including 2 eyes without improvement at 3 months. Treatment modality, age, presence of sphenoid/ethmoid sinus hemorrhage, and abnormal FVEP were significantly associated with visual prognosis (all P<0.05). No significant adverse reactions were observed in the EPO group. Conclusion EPO therapy can moderately improve visual prognosis in TON patients and may serve as a clinical adjunctive treatment for TON. (Ophthalmol CHN, 2025, 34: 131-136)

Key words:  erythropoietin, traumatic optic neuropathy