OUTCOME FOLLOWING STEROID THERAPY IN CASES WITH ACUTE OPTIC NEUROPATHY REPORTING TO TERTIARY CARE CENTER

KANSHANA SURENDRA SINGH; GUPTA SONIKA; AISHWARYA G; BANSAL HARESH

doi:10.22159/ajpcr.2024v17i9.51698

Authors

KANSHANA SURENDRA SINGH 1Department of Ophthalmology, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India. https://orcid.org/0000-0003-0746-5831
GUPTA SONIKA Department of Physiology, G.R. Medical College, Gwalior, Madhya Pradesh, India. https://orcid.org/0009-0000-2065-8860
AISHWARYA G Department of Ophthalmology, Nandkumar Singh Chouhan Government Medical College, Khandwa, Madhya Pradesh, India. https://orcid.org/0000-0001-7509-8119
BANSAL HARESH Department of Pharmacology, JNUIMSRC, Jaipur, Rajasthan, India. https://orcid.org/0000-0002-3365-0603

DOI:

https://doi.org/10.22159/ajpcr.2024v17i9.51698

Keywords:

Traumatic optic neuropathy, Anterior ischemic optic neuropathy, Optic neuritis, Steroid therapy

Abstract

Objectives: The objective of the study was to evaluate the etiological factors in patients of acute optic neuropathy reporting to tertiary care centers and response to steroid therapy in acute optic neuropathy.

Methods: All the patients selected were subjected to the detailed ocular examination which included best-corrected visual acuity and fundus examination. After ocular and systemic examination and relevant investigations, the underlying etiological diagnosis of acute optic neuropathy was established after this, they were started on intravenous methylprednisolone followed by oral prednisolone.

Results: A total of 30 patients with acute optic neuropathy presented in the tertiary care center during the study period. A visual improvement of more than two lines, after steroid therapy, was observed in 54.5% of cases of traumatic optic neuropathy, 53.8% of cases of optic neuritis, and 33.3% of cases of anterior ischemic optic neuropathy.

Conclusion: Marked visual recovery and prognosis can be seen in timely managed patients. In traumatic optic neuropathy, steroid therapy should always be considered in diagnosed patients of traumatic optic neuropathy irrespective of the timing of presentation.

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References

Rath EZ. Visual loss in neuro-ophthalmology. In: Causes and Coping with Visual Impairment and Blindness. London: IntechOpen; 2018.

Beck RW, Cleary PA, Jye-Yu C, Optic Neuritis Study Group. The course of visual recovery after optic neuritis: Experience of the Optic Neuritis Treatment Trial. Ophthalmology. 1994 Nov 1;101(11):1771-8.

Hickman SJ, Dalton CM, Miller DH, Plant GT. Management of acute optic neuritis. Lancet. 2002 Dec 14;360(9349):1953-62.

Pandey R, Bihari R. Etiological profile of optic neuropathy in tertiary hospital in Eastern India- a cross sectional observational study. Int J Sci Eng Res. 2017 Apr;8(4):1144-55.

Miller NR, Arnold AC. Current concepts in the diagnosis, pathogenesis and management of nonarteritic anterior ischaemic optic neuropathy. Eye (Lond). 2015 Jan;29(1):65-79.

Repka MX, Savino PJ, Schatz NJ, Sergott RC. Clinical profile and long-term implications of anterior ischemic optic neuropathy. Am J Ophthalmol. 1983;96(4):478-83.

Sivakumar P, Devy N, Vedachalam R. Clinical profile and visual outcomes of traumatic optic neuropathy. TNOA J Ophthalmic Sci Res. 2018;56(1):3-7.

Kim DH, Shin GR, Choi YJ. Risk factors for non-arteritic anterior ischaemic optic neuropathy in a Korean population. Neuroophthalmology. 2017;41(2):68-75.

Pandit L, Shetty R, Misri Z, Bhat S, Amin H, Pai V, et al. Optic neuritis: Experience from a south Indian demyelinating disease registry. Neurol India. 2012;60:470-5.

Atkins EJ, Bruce BB, Newman NJ, Biousse V. Treatment of nonarteritic anterior ischemic optic neuropathy. Surv Ophthalmol. 2010 Jan 1;55(1):47-63.

Bendel RE, McHenry JG, Ramocki JM, Spoor TC. Traumatic optic neuropathy and intravenous megadose corticosteroids. Invest Ophthalmol Vis Sci. 1993 Mar;34(4):1215.

Levin LA, Beck RW, Joseph MP, Seiff S, Kraker R. The treatment of traumatic optic neuropathy: The International Optic Nerve Trauma Study. Ophthalmology. 1999;106(7):1268-77.

Sadeghi-Tari A, Lasheyei AR, Tabassi A. Visual outcome of traumatic optic neuropathy in patients treated with intravenous megadose of steroids. Acta Medica Iranica. 2005;43:110-4.

Emmatty JJ, Narayan S, Cherayath RK. Trial for a trial: Is there hope?- Optic neuritis treatment trial protocol in patients with traumatic optic neuropathy. Kerala J Ophthalmol. 2020;32(3):258-62.

Lee KF, Nor NI, Yaakub A, Hitam WH. Traumatic optic neuropathy: A review of 24 patients. Int J Ophthalmol. 2010;3(2):175-8.