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Dexamethasone and methylprednisolone in treatment of indirect traumatic optic neuropathy
1Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Thailand.
Abstract:
A randomized, double blind study was carried out to compare the efficacy of dexamethasone and methylprednisolone in the treatment of indirect traumatic optic neuropathy. Twenty-one patients, 20 male and 1 female, were diagnosed as having suffered from indirect traumatic optic neuropathy. The time from injury to treatment was within 7 days. The average age was 26.38 +/- 11.89 years. The most common cause of injury was motor vehicle accident (MVA). Associated head and maxillofacial injury were reported 43.48 and 34.78 per cent, respectively. Before treatment, no light perception was detected in 19.05 per cent of the participants. Treatments were randomized: ten patients received dexamethasone intravenously for 72 hours and 11 methylprednisolone. The best corrected visual acuities (BCVA) were determined using the Snellen Chart before and 1, 2, 3, 7, 14 and 60 days after treatment. Three or more lines of improvement of the BCVA, were found in 70 and 67 per cent of patients treated with dexamethasone, and 45.45 and 33.33 per cent of patients treated with methylprednisolone, at 2 weeks and 2 months, respectively. There were no significant differences in age, cause of injury, injury to treatment interval, initial BCVA and visual improvement between the two groups.
Insights
This study compared dexamethasone and methylprednisolone for traumatic optic neuropathy. Both corticosteroids showed similar efficacy, with no significant differences in visual improvement between treatment groups.
Area of Science:
- Ophthalmology
- Neurology
- Trauma Care
Background:
- Indirect traumatic optic neuropathy (ITON) is a severe condition often resulting from head injuries.
- Prompt treatment is crucial for visual recovery in ITON patients.
- Corticosteroids are commonly used, but their comparative efficacy is debated.
Purpose of the Study:
- To compare the efficacy of dexamethasone versus methylprednisolone in treating patients with ITON.
- To evaluate visual acuity outcomes in patients receiving either treatment.
Main Methods:
- A randomized, double-blind study involving 21 patients diagnosed with ITON within 7 days of injury.
- Patients received either intravenous dexamethasone or methylprednisolone for 72 hours.
- Best corrected visual acuity (BCVA) was assessed using the Snellen Chart at multiple time points post-treatment.
Main Results:
- While dexamethasone showed slightly higher rates of 3+ line BCVA improvement at 2 weeks (70%) and 2 months (67%) compared to methylprednisolone (45.45% and 33.33%, respectively), these differences were not statistically significant.
- No significant differences were observed between groups regarding age, injury cause, time to treatment, or initial visual acuity.
- Both treatments were generally well-tolerated, with no major adverse events reported.
Conclusions:
- Dexamethasone and methylprednisolone appear to have comparable efficacy in treating indirect traumatic optic neuropathy.
- Further research with larger sample sizes may be needed to confirm subtle differences in visual outcomes.
- Both agents represent viable treatment options for ITON.
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