Comparative evaluation of megadose methylprednisolone with dexamethasone for treatment of primary typical optic neuritis

Abstract

Aim: To compare the efficacy of intravenous methylprednisolone and intravenous dexamethasone on visual recovery and evaluate their side-effects for the treatment of optic neuritis.Materials and Methods: Prospective, randomized case-controlled study including 21 patients of acute optic neuritis presenting within eight days of onset and with visual acuity less then 20/60 in the affected eye who were randomly divided into two groups. Group I received intravenous dexamethasone 200 mg once daily for three days and Group II received intravenous methylprednisolone 250 mg/six-hourly for three days followed by oral prednisolone for 11 days. Parameters tested were pupillary reactions, visual acuity, fundus findings, color vision, contrast sensitivity, Goldmann visual fields and biochemical investigations for all patients at presentation and follow-up.Results: Both groups were age and sex-matched. LOGMAR visual acuity at presentation was 1.10 ± 0.52 in Group I and 1.52 ± 0.43 in Group II. On day 90 of steroid therapy, visual acuity improved to 0.28 ± 0.33 in Group I and 0.36 ± 0.41 in Group II ( P =0.59). At three months there was no statistically significant difference in the color vision, contrast sensitivity, stereoacuity, Goldman fields and the amplitude and latency of visually evoked response between the two groups. The concentration of vitamin C, glucose, sodium, potassium, urea and creatinine were within the reported normal limits.Conclusion: Intravenous dexamethasone is an effective treatment for optic neuritis. However, larger studies are required to establish it as a safe, inexpensive and effective modality for the treatment of optic neuritis.

The effect of optic neuritis treatment trial (ONTT) combined corticosteroid regimen on pattern reversal visual evoked potentials: a prospective follow-up study

“…Our findings are consistent with those of the original ONTT study and other prospective studies that investigated the effect of combined ONTT regimen on visual acuity, colour vision, visual fields and contrast sensitivity in patients with optic neuritis [ 1 , 22 – 24 ]. The follow up data from the original ONTT study shows that the combined ONTT regimen elicits a significant improvement in visual acuity, contrast sensitivity and visual fields sooner than the placebo group and the group treated with oral prednisolone [ 1 , 25 ].…”

The effect of optic neuritis treatment trial (ONTT) combined corticosteroid regimen on pattern reversal visual evoked potentials: a prospective follow-up study

“…Our findings are consistent with those of the original ONTT study and other prospective studies that investigated the effect of combined ONTT regimen on visual acuity, colour vision, visual fields and contrast sensitivity in patients with optic neuritis [ 1 , 22 – 24 ]. The follow up data from the original ONTT study shows that the combined ONTT regimen elicits a significant improvement in visual acuity, contrast sensitivity and visual fields sooner than the placebo group and the group treated with oral prednisolone [ 1 , 25 ].…”

Tapering Oral Steroid Treatment After IV Methylprednisolone Pulse Therapy in Demyelinating Optic Neuritis

“…The present study assessed the outcome of two visual parameters after treatment with oral prednisolone after IV methylprednisolone in cases of optic neuritis. The mean age of our patients was (27.8 years) younger than of patients in Optic Neuritis Treatment Trial (ONTT) (32 years) and 65% of our patients were female which were less than that study (77%) [19]. In our study males and females were equally represented in both groups.…”

Comparison of the Structure and Function of the Retina and the Optic Nerve in Patients with a History of Multiple Sclerosis-Related Demyelinating Retrobulbar Optic Neuritis Treated and Not Treated with Systemic Steroid Therapy

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The effect of optic neuritis treatment trial (ONTT) combined corticosteroid regimen on pattern reversal visual evoked potentials: a prospective follow-up study

“…Our findings are consistent with those of the original ONTT study and other prospective studies that investigated the effect of combined ONTT regimen on visual acuity, colour vision, visual fields and contrast sensitivity in patients with optic neuritis [ 1 , 22 – 24 ]. The follow up data from the original ONTT study shows that the combined ONTT regimen elicits a significant improvement in visual acuity, contrast sensitivity and visual fields sooner than the placebo group and the group treated with oral prednisolone [ 1 , 25 ].…”

Tapering Oral Steroid Treatment After IV Methylprednisolone Pulse Therapy in Demyelinating Optic Neuritis

“…The present study assessed the outcome of two visual parameters after treatment with oral prednisolone after IV methylprednisolone in cases of optic neuritis. The mean age of our patients was (27.8 years) younger than of patients in Optic Neuritis Treatment Trial (ONTT) (32 years) and 65% of our patients were female which were less than that study (77%) [19]. In our study males and females were equally represented in both groups.…”

Comparison of the Structure and Function of the Retina and the Optic Nerve in Patients with a History of Multiple Sclerosis-Related Demyelinating Retrobulbar Optic Neuritis Treated and Not Treated with Systemic Steroid Therapy

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The effect of optic neuritis treatment trial (ONTT) combined corticosteroid regimen on pattern reversal visual evoked potentials: a prospective follow-up study

“…Our findings are consistent with those of the original ONTT study and other prospective studies that investigated the effect of combined ONTT regimen on visual acuity, colour vision, visual fields and contrast sensitivity in patients with optic neuritis [ 1 , 22 – 24 ]. The follow up data from the original ONTT study shows that the combined ONTT regimen elicits a significant improvement in visual acuity, contrast sensitivity and visual fields sooner than the placebo group and the group treated with oral prednisolone [ 1 , 25 ].…”

Tapering Oral Steroid Treatment After IV Methylprednisolone Pulse Therapy in Demyelinating Optic Neuritis

“…The present study assessed the outcome of two visual parameters after treatment with oral prednisolone after IV methylprednisolone in cases of optic neuritis. The mean age of our patients was (27.8 years) younger than of patients in Optic Neuritis Treatment Trial (ONTT) (32 years) and 65% of our patients were female which were less than that study (77%) [19]. In our study males and females were equally represented in both groups.…”

Comparison of the Structure and Function of the Retina and the Optic Nerve in Patients with a History of Multiple Sclerosis-Related Demyelinating Retrobulbar Optic Neuritis Treated and Not Treated with Systemic Steroid Therapy

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