High-dose intravenous methylprednisolone in recent traumatic optic neuropathy; a randomized double-masked placebo-controlled clinical trial

Abstract

Our study confirms earlier findings that there is no difference in visual acuity improvement between intravenous high-dose corticosteroids and placebo in treatment of recent TNO.

Erythropoietin: a novel treatment for traumatic optic neuropathy—a pilot study

“…The results of these medical and surgical interventions have shown to be uncertain [5][6][7] with possible serious side-effects or complications [8,9]. At present, no study could validate a particular approach to the management of TON [4].…”

Levodopa-Carbidopa May Improve Vision Loss in Indirect Traumatic Optic Neuropathy

“…An important question that needs to be considered when interpreting the current results is whether the improvements in visual acuity seen were the result of levodopa or steroids. Based on the studies that found no benefit of steroid therapy in patients with TON, the visual improvements seen here may be attributable to levodopa (Entezari et al, 2007;Levin et al, 1999). Additionally, the possibility of spontaneous visual acuity improvement cannot be ruled out.…”

“…Recently, in a double-blind placebo-controlled clinical trial of 31 patients, Entezari and associates (Entezari et al, 2007) found no benefit resulting from high-dose steroid therapy compared to intravenous normal saline. This was compatible with the International Optic Nerve Trauma Study, a comparative, nonrandomized interventional study that showed that no clear benefit was obtained by either corticosteroid therapy or optic canal decompression surgery (Levin et al, 1999).…”

“…Multiple options have been recommended, including high-dose (Seiff, 1990) or low-dose corticosteroids (Yip et al, 2002), decompression of the canalicular portion of the optic nerve with and without systemic corticosteroids (Mauriello et al 1992;Thakar et al 2003;Wohlrab et al 2002), and observation (Entezari et al, 2007;Lubben et al 2001).…”

The Assessment of Orbital Apical Temperature Change With Local Cool Compress Application

“…The most extensive studies in this regard in the literature have shown that treatment by corticosteroids, surgical decompression, or a combination of both may not be beneficial. 5,6 Spontaneous recovery may occur in 30% of patients. 7 Induced hypothermia, both systemic and local, was studied as a neuroprotective intervention for mitigating secondary neuronal injury that follows the initial damage to the central nervous system after traumatic brain 8,9 and spinal cord 10 injury.…”