Visual recovery after oral high-dose methylprednisolone in acute inflammatory optic neuropathy.

Autor: Boureaux E; Ophthalmology Department, CHU Rennes, Université Rennes 1, Rennes, France., Laurent C; Ophthalmology Department, CHU Rennes, Université Rennes 1, Rennes, France., Rodriguez T; Ophthalmology Department, CHU Rennes, Université Rennes 1, Rennes, France., Le Page E; Neurology Department, CRC-SEP Rennes, University Hospital Pontchaillou, CIC1414 INSERM35033, Rennes, France., Mouriaux F; Ophthalmology Department, CHU Rennes, Université Rennes 1, Rennes, France. frederic.mouriaux@chu-rennes.fr.; CUO-Recherche, Centre de Recherche du CHU de Québec - Université Laval, Axe Médecine Régénératrice, Hôpital du Saint-Sacrement, Québec, Canada. frederic.mouriaux@chu-rennes.fr.
Jazyk: angličtina
Zdroj: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie [Graefes Arch Clin Exp Ophthalmol] 2024 Dec; Vol. 262 (12), pp. 3979-3985. Date of Electronic Publication: 2024 Jul 31.
DOI: 10.1007/s00417-024-06568-w
Abstrakt: Purpose: 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.
Competing Interests: Declarations. Ethical Approval: The study was approved by the ethics committee of the Rennes university hospital (approval number 20.54). Informed Patient consent: As this is a retrospective study started before 2016 in France, the agreement of the ethics committee is required-see above but informed consent was not necessary. Conflicts of interests: No Conflicts of Interest: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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