Additional Retrobulbar Triamcinolone Acetonide Injection for Retrobulbar Optic Neuritis Patients

ABSTRACT

PURPOSE: To evaluate the effect of additional retrobulbar triamcinolone acetonide (TA) injection on early recovery of visual acuity in retrobulbar optic neuritis patients. METHODS: A prospective, randomized clinical study including 30 patients with retrobulbar optic neuritis was conducted between March 2003 and June 2007. Patients were divided into 2 groups Group 1 (n = 9) with retrobulbar triamcinolone (TA, 40 mg/1 ml) injection on the first day of ONTT protocol, and group 2 (n = 21) with conventional ONTT protocol. The following parameters were measured and analyzed patient's sex, age, pupillary reactions, color vision, visual field, and best-corrected visual acuity before treatment, and after 1 day, 1 week, 2 weeks, 1 month, and 3 months of follow-up. RESULTS: Mean visual acuity before treatment was 1.00 +/- 0.89 log MAR units in group 1 and 0.98 +/- 0.75 log MAR units in group 2. One day after injection, visual acuity was better in group 1 (0.50 +/- 0.42 log MAR units) than in group 2 (0.73 +/- 0.61 log MAR units), however, there was no statistically significant difference between the 2 groups (p = 0.07). There was no significant difference in visual acuity, recovery of RAPD, color vision, or visual field at 3 months of follow-up. No serious side effect related to retrobulbar TA injection was observed. CONCLUSIONS: Additional retrobulbar TA injection may help optic neuritis patients who have a need for prompt visual recovery. However, further studies are required to ascertain whether this procedure can help early recovery of visual acuity in retrobulbar optic neuritis patients.