[High dose intravenous corticosteroid versus placebo in recent traumatic optic neuropathy]

ABSTRACT

To compare the effect of high dose intravenous corticosteroid therapy with placebo in the treatment of recent traumatic optic neuropathy [TON]. In double masked-placebo controlled clinical trial, 31 eyes of 31 patients were randomly assigned into two groups. Only patients with history of ophthalmic or head trauma within the past 7 days were included. Unconscious patients, with penetrating ocular injury, and candidates for decompression surgery were excluded. The treatment group [16 eyes] received 1 gr methylprednisolone intravenously for 3 days followed by 1 mg/kg prednisolone orally for 11 days. The placebo group [15eyes] received 50 ml normal saline intravenously every 6 hours for 3 days. Visual improvement was defined as increase of at least 0.3 logMAR visual acuity after 3 month. Visual improvement was achieved in 68.8% of the treatment group and 53.3% of the placebo group [P=0.1]. Visual improvement in the first 48 hours was correlated with final visual acuity [P=0.03] but final visual acuity was not significantly correlated with age [P0.06], interval from trauma to treatment [P=0.5], and initial visual acuity [P=0.06]. In patients with recent TON, high-dose intravenous corticosteroids and placebo are comparable in terms of improvement in visual acuity