Skip to main content
Top
Published in: BMC Ophthalmology 1/2014

Open Access 01-12-2014 | Research article

Visual outcome of mega-dose intravenous corticosteroid treatment in non-arteritic anterior ischemic optic neuropathy – retrospective analysis

Authors: Michael Kinori, Iris Ben-Bassat, Yael Wasserzug, Angela Chetrit, Ruth Huna-Baron

Published in: BMC Ophthalmology | Issue 1/2014

Login to get access

Abstract

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.
Appendix
Available only for authorised users
Literature
1.
go back to reference Hattenhauer MG, Leavitt JA, Hodge DO, Grill R, Gray DT: Incidence of nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1997, 123 (1): 103-107.CrossRefPubMed Hattenhauer MG, Leavitt JA, Hodge DO, Grill R, Gray DT: Incidence of nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1997, 123 (1): 103-107.CrossRefPubMed
2.
go back to reference Hayreh SS: Blood supply of the optic nerve head and its role in optic atrophy, glaucoma, and oedema of the optic disc. Br J Ophthalmol. 1969, 53 (11): 721-748.CrossRefPubMedPubMedCentral Hayreh SS: Blood supply of the optic nerve head and its role in optic atrophy, glaucoma, and oedema of the optic disc. Br J Ophthalmol. 1969, 53 (11): 721-748.CrossRefPubMedPubMedCentral
3.
go back to reference Atkins EJ, Bruce BB, Newman NJ, Biousse V: Translation of clinical studies to clinical practice: survey on the treatment of nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 2009, 148 (5): 809-CrossRefPubMed Atkins EJ, Bruce BB, Newman NJ, Biousse V: Translation of clinical studies to clinical practice: survey on the treatment of nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 2009, 148 (5): 809-CrossRefPubMed
4.
go back to reference IONDT: Optic nerve decompression surgery for nonarteritic anterior ischemic optic neuropathy (NAION) is not effective and may be harmful. JAMA. 1995, 273 (8): 625-632.CrossRef IONDT: Optic nerve decompression surgery for nonarteritic anterior ischemic optic neuropathy (NAION) is not effective and may be harmful. JAMA. 1995, 273 (8): 625-632.CrossRef
5.
go back to reference Beck RW, Hayreh SS, Podhajsky PA, Tan ES, Moke PS: Aspirin therapy in nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1997, 123 (2): 212-217.CrossRefPubMed Beck RW, Hayreh SS, Podhajsky PA, Tan ES, Moke PS: Aspirin therapy in nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1997, 123 (2): 212-217.CrossRefPubMed
6.
go back to reference Newman NJ, Scherer R, Langenberg P, Kelman S, Feldon S, Kaufman D, Dickersin K: The fellow eye in NAION: report from the ischemic optic neuropathy decompression trial follow-up study. Am J Ophthalmol. 2002, 134 (3): 317-328.CrossRefPubMed Newman NJ, Scherer R, Langenberg P, Kelman S, Feldon S, Kaufman D, Dickersin K: The fellow eye in NAION: report from the ischemic optic neuropathy decompression trial follow-up study. Am J Ophthalmol. 2002, 134 (3): 317-328.CrossRefPubMed
7.
go back to reference Botelho PJ, Johnson LN, Arnold AC: The effect of aspirin on the visual outcome of nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1996, 121 (4): 450-451.CrossRefPubMed Botelho PJ, Johnson LN, Arnold AC: The effect of aspirin on the visual outcome of nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1996, 121 (4): 450-451.CrossRefPubMed
8.
go back to reference Bonamour MG: [Apropos of “vascular pseudo-papillitis”]. Bull Soc Ophtalmol Fr. 1966, 66 (9): 846-850.PubMed Bonamour MG: [Apropos of “vascular pseudo-papillitis”]. Bull Soc Ophtalmol Fr. 1966, 66 (9): 846-850.PubMed
9.
go back to reference Haas A, Walzl M, Jesenik F, Walzl B, Berghold A, Bergloff J, Feigl B, Faulborn J: Application of HELP in nonarteritic anterior ischemic optic neuropathy: a prospective, randomized, controlled study. Graefes Arch Clin Exp Ophthalmol. 1997, 235 (1): 14-19.CrossRefPubMed Haas A, Walzl M, Jesenik F, Walzl B, Berghold A, Bergloff J, Feigl B, Faulborn J: Application of HELP in nonarteritic anterior ischemic optic neuropathy: a prospective, randomized, controlled study. Graefes Arch Clin Exp Ophthalmol. 1997, 235 (1): 14-19.CrossRefPubMed
10.
go back to reference Arnold AC, Hepler RS, Lieber M, Alexander JM: Hyperbaric oxygen therapy for nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1996, 122 (4): 535-541.CrossRefPubMed Arnold AC, Hepler RS, Lieber M, Alexander JM: Hyperbaric oxygen therapy for nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1996, 122 (4): 535-541.CrossRefPubMed
11.
go back to reference Ellenberger C, Burde RM, Keltner JL: Acute optic neuropathy. Treatment with diphenylhydantoin. Arch Ophthalmol. 1974, 91 (6): 435-438.CrossRefPubMed Ellenberger C, Burde RM, Keltner JL: Acute optic neuropathy. Treatment with diphenylhydantoin. Arch Ophthalmol. 1974, 91 (6): 435-438.CrossRefPubMed
12.
go back to reference Kollarits CR, McCarthy RW, Corrie WS, Swann ER: Norepinephrine therapy of ischemic optic neuropathy. J Clin Neuroophthalmol. 1981, 1 (4): 283-288.PubMed Kollarits CR, McCarthy RW, Corrie WS, Swann ER: Norepinephrine therapy of ischemic optic neuropathy. J Clin Neuroophthalmol. 1981, 1 (4): 283-288.PubMed
13.
go back to reference Johnson LN, Guy ME, Krohel GB, Madsen RW: Levodopa may improve vision loss in recent-onset, nonarteritic anterior ischemic optic neuropathy. Ophthalmology. 2000, 107 (3): 521-526.CrossRefPubMed Johnson LN, Guy ME, Krohel GB, Madsen RW: Levodopa may improve vision loss in recent-onset, nonarteritic anterior ischemic optic neuropathy. Ophthalmology. 2000, 107 (3): 521-526.CrossRefPubMed
15.
go back to reference Wilhelm B, Ludtke H, Wilhelm H: Efficacy and tolerability of 0.2% brimonidine tartrate for the treatment of acute non-arteritic anterior ischemic optic neuropathy (NAION): a 3-month, double-masked, randomised, placebo-controlled trial. Graefes Arch Clin Exp Ophthalmol. 2006, 244 (5): 551-558.CrossRefPubMed Wilhelm B, Ludtke H, Wilhelm H: Efficacy and tolerability of 0.2% brimonidine tartrate for the treatment of acute non-arteritic anterior ischemic optic neuropathy (NAION): a 3-month, double-masked, randomised, placebo-controlled trial. Graefes Arch Clin Exp Ophthalmol. 2006, 244 (5): 551-558.CrossRefPubMed
16.
go back to reference Prescott CR, Sklar CA, Lesser RL, Adelman RA: Is intravitreal bevacizumab an effective treatment option for nonarteritic anterior ischemic optic neuropathy?. J Neuroophthalmol. 2012, 32 (1): 51-53.CrossRefPubMed Prescott CR, Sklar CA, Lesser RL, Adelman RA: Is intravitreal bevacizumab an effective treatment option for nonarteritic anterior ischemic optic neuropathy?. J Neuroophthalmol. 2012, 32 (1): 51-53.CrossRefPubMed
17.
go back to reference Rootman DB, Gill HS, Margolin EA: Intravitreal bevacizumab for the treatment of nonarteritic anterior ischemic optic neuropathy: a prospective trial. Eye (Lond). 2013, 27 (4): 538-544.CrossRef Rootman DB, Gill HS, Margolin EA: Intravitreal bevacizumab for the treatment of nonarteritic anterior ischemic optic neuropathy: a prospective trial. Eye (Lond). 2013, 27 (4): 538-544.CrossRef
19.
go back to reference Hayreh SS, Zimmerman MB: Non-arteritic anterior ischemic optic neuropathy: role of systemic corticosteroid therapy. Graefes Arch Clin Exp Ophthalmol. 2008, 246 (7): 1029-1046.CrossRefPubMedPubMedCentral Hayreh SS, Zimmerman MB: Non-arteritic anterior ischemic optic neuropathy: role of systemic corticosteroid therapy. Graefes Arch Clin Exp Ophthalmol. 2008, 246 (7): 1029-1046.CrossRefPubMedPubMedCentral
20.
go back to reference Prokosch V, Thanos S: Visual outcome of patients following NAION after treatment with adjunctive fluocortolone. Restor Neurol Neurosci. 2013, [Epub ahead of print] Prokosch V, Thanos S: Visual outcome of patients following NAION after treatment with adjunctive fluocortolone. Restor Neurol Neurosci. 2013, [Epub ahead of print]
21.
go back to reference Foulds WS: Visual disturbances in systemic disorders. Optic neuropathy and systemic disease. Trans Ophthalmol Soc U K. 1970, 89: 125-146.PubMed Foulds WS: Visual disturbances in systemic disorders. Optic neuropathy and systemic disease. Trans Ophthalmol Soc U K. 1970, 89: 125-146.PubMed
22.
go back to reference Hayreh SS: Treatment of non-arteritic anterior ischaemic optic neuropathy. Br J Ophthalmol. 2011, 95 (11): 1617-1618.CrossRefPubMed Hayreh SS: Treatment of non-arteritic anterior ischaemic optic neuropathy. Br J Ophthalmol. 2011, 95 (11): 1617-1618.CrossRefPubMed
23.
go back to reference Lee AG, Biousse V: Should steroids be offered to patients with nonarteritic anterior ischemic optic neuropathy?. J Neuroophthalmol. 2010, 30 (2): 193-198.CrossRefPubMedPubMedCentral Lee AG, Biousse V: Should steroids be offered to patients with nonarteritic anterior ischemic optic neuropathy?. J Neuroophthalmol. 2010, 30 (2): 193-198.CrossRefPubMedPubMedCentral
24.
go back to reference Beck RW, Cleary PA, Anderson MM, Keltner JL, Shults WT, Kaufman DI, Buckley EG, Corbett JJ, Kupersmith MJ, Miller NR, Savino PJ, Guy JR, Trobe JD, McCrary JA, Smith CH, Chrousos GA, Thompson HS, Katz BJ, Brodsky MC, Goodwin JA, Atwell CW, the Optic Neuritis Study Group: A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med. 1992, 326 (9): 581-588.CrossRefPubMed Beck RW, Cleary PA, Anderson MM, Keltner JL, Shults WT, Kaufman DI, Buckley EG, Corbett JJ, Kupersmith MJ, Miller NR, Savino PJ, Guy JR, Trobe JD, McCrary JA, Smith CH, Chrousos GA, Thompson HS, Katz BJ, Brodsky MC, Goodwin JA, Atwell CW, the Optic Neuritis Study Group: A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med. 1992, 326 (9): 581-588.CrossRefPubMed
25.
go back to reference Slater BJ, Mehrabian Z, Guo Y, Hunter A, Bernstein SL: Rodent anterior ischemic optic neuropathy (rAION) induces regional retinal ganglion cell apoptosis with a unique temporal pattern. Invest Ophthalmol Vis Sci. 2008, 49 (8): 3671-3676.CrossRefPubMedPubMedCentral Slater BJ, Mehrabian Z, Guo Y, Hunter A, Bernstein SL: Rodent anterior ischemic optic neuropathy (rAION) induces regional retinal ganglion cell apoptosis with a unique temporal pattern. Invest Ophthalmol Vis Sci. 2008, 49 (8): 3671-3676.CrossRefPubMedPubMedCentral
26.
go back to reference Rebolleda G, Perez-Lopez M, Casas-Llera P, Contreras I, Munoz-Negrete FJ: Visual and anatomical outcomes of non-arteritic anterior ischemic optic neuropathy with high-dose systemic corticosteroids. Graefes Arch Clin Exp Ophthalmol. 2013, 251 (1): 255-260.CrossRefPubMed Rebolleda G, Perez-Lopez M, Casas-Llera P, Contreras I, Munoz-Negrete FJ: Visual and anatomical outcomes of non-arteritic anterior ischemic optic neuropathy with high-dose systemic corticosteroids. Graefes Arch Clin Exp Ophthalmol. 2013, 251 (1): 255-260.CrossRefPubMed
27.
go back to reference Chen CS, Johnson MA, Flower RA, Slater BJ, Miller NR, Bernstein SL: A primate model of nonarteritic anterior ischemic optic neuropathy. Invest Ophthalmol Vis Sci. 2008, 49 (7): 2985-2992.CrossRefPubMedPubMedCentral Chen CS, Johnson MA, Flower RA, Slater BJ, Miller NR, Bernstein SL: A primate model of nonarteritic anterior ischemic optic neuropathy. Invest Ophthalmol Vis Sci. 2008, 49 (7): 2985-2992.CrossRefPubMedPubMedCentral
28.
go back to reference Jonas JB, Spandau UH, Harder B, Sauder G: Intravitreal triamcinolone acetonide for treatment of acute nonarteritic anterior ischemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol. 2007, 245 (5): 749-750.CrossRefPubMed Jonas JB, Spandau UH, Harder B, Sauder G: Intravitreal triamcinolone acetonide for treatment of acute nonarteritic anterior ischemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol. 2007, 245 (5): 749-750.CrossRefPubMed
29.
go back to reference Kaderli B, Avci R, Yucel A, Guler K, Gelisken O: Intravitreal triamcinolone improves recovery of visual acuity in nonarteritic anterior ischemic optic neuropathy. J Neuroophthalmol. 2007, 27 (3): 164-168.CrossRefPubMed Kaderli B, Avci R, Yucel A, Guler K, Gelisken O: Intravitreal triamcinolone improves recovery of visual acuity in nonarteritic anterior ischemic optic neuropathy. J Neuroophthalmol. 2007, 27 (3): 164-168.CrossRefPubMed
Metadata
Title
Visual outcome of mega-dose intravenous corticosteroid treatment in non-arteritic anterior ischemic optic neuropathy – retrospective analysis
Authors
Michael Kinori
Iris Ben-Bassat
Yael Wasserzug
Angela Chetrit
Ruth Huna-Baron
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2014
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/1471-2415-14-62

Other articles of this Issue 1/2014

BMC Ophthalmology 1/2014 Go to the issue