S. Morteza Entezari, MD (Tehran, Iran), Zhaleh Rajavi, MD (Tehran, Iran), Neda Sedighi, MD (Tehran, Iran), Narssis Daftarian, MD (Tehran, Iran)


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


In a double masked- placebo controlled clinical trial 31 eyes of 31 patients were randomly assigned to two groups. The patients with history of trauma =7 days were included. Unconscious patients, eyes with penetrating trauma and candidate for decompression surgery were excluded. The treatment group (16 eyes) received 250mg methylprednisolone intravenously every 6 hours for 3 days then 1 mg/ Kg prednisolone orally for 11 days, the placebo group (15 eyes) received 50ml normal saline intravenously every 6 hours for 3 days then placebo for 11 days. Visual improvement was considered as decrease of 0.3 log MAR in final visual acuity.


Mean of BCVA in treatment group was 1.11±1.14 and 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 detected
statistically significant (P<0.001 and 0.010 respectively). After adjustment of initial BCVA the difference between both groups was statistically significant (P=0.05).


There is no difference in visual acuity improvement between intravenous high dose corticosteroid and placebo in the treatment of recent TON.