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Visual Recovery After Oral High-Dose Methylprednisolone in Acute Inflammatory Optic Neuropathy
TAKE-HOME MESSAGE
- In this study, the authors examined the visual outcomes and relapse rates in patients with optic neuritis (ON) treated with oral high-dose methylprednisolone. After high-dose oral methylprednisolone, 50.0% of patients had returned to normal visual acuity by 15 days and 82.4% at 6 months. Improvement in contrast sensitivity also occurred within 4 days after treatment, with most of the recovery occurring in the first 15 days. At 6 years of follow-up, 2 of 25 patients experienced a new episode of ON. Visual field alterations also significantly improved, with a return to near-normal values 30 days post treatment.
- Oral high-dose methylprednisolone may represent a safe and efficacious treatment for visual recovery in patients with ON.
abstract
This abstract is available on the publisher's site.
Access this abstract nowPURPOSE
High doses of venous corticosteroids are currently the only validated treatment for the management of optic neuritis (ON). The objective is to assess the changes in visual function parameters after oral high-dose methylprednisolone in patients with ON.
METHODS
A retrospective analysis of patients with acute ON was performed. Patients received 1 g per day of oral methylprednisolone for 3 to 5 days. Visual function was measured using the ETDRS test for visual acuity, 30-2 automated visual field test, contrast sensitivity test, and color vision test before treatment, 4 days, 2 weeks, 1 month and 3 months, and 6 months following treatment. To assess anatomical changes, optical coherence tomography of the ganglion cells was performed at various timepoints.
RESULTS
Between September 2014 and September 2016, a total of 29 patients were included in the study. More than 80% of patients had recovered normal visual acuity after 3 and 6 months. This recovery of all parameters of visual function was observed as early as 4 days but occurred predominantly within 15 days after the initiation of treatment. We observed a thinning of the ganglion cell layer during the follow-up, which mainly occurs within one month. The P100 wave of visually evoked potentials was discernible in all patients at 6 months. During the 6 years of follow-up, 2 patients had experienced a relapse of ON. No serious adverse effects were observed.
CONCLUSION
This study demonstrated a rapid recovery of all visual function parameters after oral high-dose methylprednisolone ON with no serious adverse effects.
Additional Info
Visual recovery after oral high-dose methylprednisolone in acute inflammatory optic neuropathy
Graefes Arch. Clin. Exp. Ophthalmol 2024 Dec 01;262(12)3979-3985, E Boureaux, C Laurent, T Rodriguez, E Le Page, F MouriauxFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.