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High-dose intravenous methylprednisolone in recent traumatic optic neuropathy; a randomized double-masked placebo-controlled clinical trial

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Abstract

Background

To compare the effect of high-dose intravenous corticosteroid therapy with placebo in the treatment of recent traumatic optic neuropathy (TON).

Methods

In a double-masked placebo-controlled clinical trial, 31 eyes of 31 patients were randomly assigned to two groups. Patients with history of trauma ≤7 days were included. Unconscious patients, eyes with penetrating trauma and candidates for decompression surgery were excluded. The treatment group (16 eyes) received 250 mg methylprednisolone intravenously every 6 h for 3 days, then 1 mg/kg prednisolone orally for 14 days; the placebo group (15 eyes) received 50 ml normal saline intravenously every 6 h for 3 days, then placebo for 14 days. Visual improvement was considered as a decrease of at least 0.4 logMAR in final visual acuity.

Results

Mean final BCVA (best corrected visual acuity) in the treatment group was 1.11± 1.14 and the placebo group was 1.78 ± 1.23. This difference was not significant (P = 0.13). Visual acuity was improved in 68.8% of the treatment group and 53.3% of the placebo group, but the difference was not statistically significant (P = 0.38). The difference between initial and final BCVA in both groups was determined to be statistically significant (P < 0.001 and 0.010 respectively).

Conclusions

Our study confirms earlier findings that there is no difference in visual acuity improvement between intravenous high-dose corticosteroids and placebo in treatment of recent TNO.

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Authors and Affiliations

  1. Department of Ophthalmology, Emam Hossein Medical Center, Ophthalmic Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran

    Morteza Entezari, Zhaleh Rajavi, Neda Sedighi & Narssis Daftarian

  2. Ophthalmic Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran

    Masoumeh Sanagoo

  3. Ophthalmic Research Center, Labbafinejad Medical Center, Boostan 9th Pasdaran St, Tehran, Iran

    Morteza Entezari

Authors
  1. Morteza Entezari
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  2. Zhaleh Rajavi
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  3. Neda Sedighi
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  4. Narssis Daftarian
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  5. Masoumeh Sanagoo
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Corresponding author

Correspondence to Morteza Entezari.

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None of the authors has a financial interest in the subject matter of the presentation.

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Entezari, M., Rajavi, Z., Sedighi, N. et al. High-dose intravenous methylprednisolone in recent traumatic optic neuropathy; a randomized double-masked placebo-controlled clinical trial. Graefes Arch Clin Exp Ophthalmol 245, 1267–1271 (2007). https://doi.org/10.1007/s00417-006-0441-0

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  • DOI: https://doi.org/10.1007/s00417-006-0441-0

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