In summary, our data, with the major limitations stated above, does not suggest the superiority of IV steroid treatment over no treatment. As intravitreal corticosteroid treatment for NAION is still anecdotal [28,29], any steroid protocol for NAION patients should be used judicially. In our center, based on our experience, we chose to abandon the use of IV corticosteroids for NAION patients until a randomized control trial will prove the benefit of such treatment.

 

Kinori, Michael et al. “Visual Outcome of Mega-Dose Intravenous Corticosteroid Treatment in Non-Arteritic Anterior Ischemic Optic Neuropathy – Retrospective Analysis.” BMC Ophthalmology 14 (2014): 62. PMC. Web. 7 Sept. 2017.

 

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.

Comment