Protective effects of systemic treatment with methylprednisolone in a rodent model of non-arteritic anterior ischemic optic neuropathy (rAION)

Early Methylprednisolone Treatment Can Stabilize the Blood-Optic Nerve Barrier in a Rat Model of Anterior Ischemic Optic Neuropathy (rAION)

“…The animals receiving MP were given a first bolus dose of 30 mg/kg via intraperitoneal administration, followed by tapering doses for 2 weeks, as described in our previous report. 25,26 All the animals tolerated this treatment without any complications, and all of them survived until the end of the treatment. The rats were euthanized using CO 2 insufflation 4 weeks postinfarct.…”

“…[9][10][11][12] After the induction of ON ischemia, the breakdown of the blood-optic nerve barrier (BOB) occurs within hours, 8,13 and the recruitment of extrinsic macrophages and the activation of resident microglia at the ischemic core are identified as early as 3 days after the insult. [14][15][16][17] Functional changes such as in the amplitude of visual-evoked potentials (VEPs) were also mitigated early before the permanent degradation following rAION induction. 18 There is evidence suggesting that the administration of corticosteroids can effectively decrease tissue edema by increasing the expression levels of the occludin and claudin-5 genes and stabilizing the blood-brain barrier (BBB) in models of brain osmotic insult, as well as models of retinal diseases.…”

“…14 Systemic MP treatment showed both, the antiapoptosis of RGCs and the anti-inflammatory effect on the ON. 24,25 However, the therapeutic window for MP in the rAION model has not yet been elucidated. We hypothesized that the therapeutic window for MP is dependent on the stabilization of the BOB, as well as the infiltration level of extrinsic macrophages in the ischemic core in the ON.…”

“…16,25,28 Briefly, we used a visual electrodiagnostic system (UTAS-E3000, LKC Technologies, Gaithersburg, MD, USA) to measure the FVEP. To exclude the possibility that the contralateral fellow eye contaminated the FVEP test, we covered the fellow eye while performing the stimulation.…”

Is There A Role for Intravitreal Pharmacotherapy in the Treatment of Acute Nonarteritic Ischemic Optic Neuropathy?

“…Steroids are advocated as they can decrease the capillary permeability, supress the inflammation and thereby facilitate the resolution of optic disc edema. In fact, systemic methylprednisolone administration was shown to have a positive effect on retinal ganglion cell survival [14] . Hayreh and Zimmerman [15] investigated the visual outcome of oral 80 mg prednisolone in a large cohort of 613 acute NAION patients.…”