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

PURPOSE:

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. 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.

RESULTS:

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).

CONCLUSION:

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