Choroidal changes in eyes treated with high-dose systemic corticosteroids for optic neuritis

Area of Science:

• Ophthalmology
• Neuro-ophthalmology
• Vascular Biology

Background:

• Optic neuritis is an inflammatory condition affecting the optic nerve.
• Systemic high-dose corticosteroids are a common treatment for optic neuritis.
• The effect of these treatments on the choroidal vasculature is not well understood.

Purpose of the Study:

• To investigate the impact of systemic high-dose corticosteroids on choroidal thickness (CT) and choroidal vascularity index (CVI).
• To analyze these effects in patients with unilateral optic neuritis, comparing affected and fellow eyes.

Main Methods:

• Retrospective comparative cohort study of 38 patients with unilateral optic neuritis.
• Measurement of CT and CVI in affected and fellow eyes at baseline and follow-up points (1 week, 1 month, 3 months).
• Statistical analysis to compare changes in CT and CVI between eyes and over time.

Main Results:

• No significant baseline differences in CT or CVI between affected and fellow eyes.
• Significant decrement in CT and CVI in affected eyes by 3 months post-treatment.
• Decreased CVI observed as early as 2 weeks, while CT decreased from 1 month.
• Significant decrease in CVI also noted in fellow eyes at 3 months.

Conclusions:

• Systemic high-dose corticosteroid treatment leads to a significant reduction in choroidal thickness and vascularity index in optic neuritis patients.
• The earlier decline in CVI compared to CT suggests choroidal vasoconstriction as a potential mechanism.
• These findings highlight the systemic vascular effects of corticosteroids beyond optic nerve inflammation.