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Open Access Highly Accessed Research article

Visual outcome of mega-dose intravenous corticosteroid treatment in non-arteritic anterior ischemic optic neuropathy – retrospective analysis

Michael Kinori12*, Iris Ben-Bassat1, Yael Wasserzug1, Angela Chetrit3 and Ruth Huna-Baron1

Author Affiliations

1 Neuro-Ophthalmology unit, The Goldschleger Eye Institute, Sheba Medical Center, Tel- Hashomer, Israel affiliated to the Sackler school of medicine, Tel Aviv university, Tel Aviv, Israel

2 The Pinchas Borenstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel

3 Gertner Institute for Research and Epidemiology, Sheba Medical Center, Tel Hashomer, Ramat Gan Israel

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BMC Ophthalmology 2014, 14:62  doi:10.1186/1471-2415-14-62

Published: 3 May 2014

Abstract

Background

To date, non arteritic anterior ischemic optic neuropathy (NAION) is still incurable. We wish to evaluate the effect of intravenous (IV) corticosteroids on the visual outcome of NAION patients.

Methods

Visual parameters were retrospectively compared between NAION patients treated with IV corticosteroids and untreated NAION patients (control). Visual acuity (VA) and Humphrey automated static perimetry visual field (VF) defects of the affected eye were compared between groups at baseline, 1, 3, 6 months, and end of follow-up visits. The VF analysis consisted of number of quadrant involvements and mean deviation (MD).

Results

Each group comprised 23 patients (24 eyes). Mean initial VA was similar in the control and treatment groups (p = 0.8). VA at end of follow-up did not improve in either groups (p = 0.8 treated group, p = 0.1 control group). No improvement and no difference in VF defects were found by either quadrant analysis (p = 0.1 treated group, p = 0.5 control group) or MD analysis (p = 0.2, treated group, p = 0.9 control group). VA and VF parameters tended to be worse in the treated group, although without statistical significance.

Conclusions

Our results suggest that IV corticosteroids may not improve the visual outcome of NAION patients. Since intravenous corticosteroids could potentially cause serious adverse effects, this treatment for NAION is questionable.

Keywords:
Anterior ischemic optic neuropathy; Corticosteroids; Visual acuity; Visual field; Mean deviation