Low-dose intravenous methylprednisolone or conservative treatment in the management of traumatic optic neuropathy
To compare the efficacy of low-dose intravenous methylprednisolone or conservative treatment in the management of traumatic optic neuropathy. A non-randomized retrospective study of 21 patients (21 eyes) with traumatic optic neuropathy treated between October 95 and November 97 in a tertiary ophthal...
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| Veröffentlicht in: | European journal of ophthalmology 2002-07, Vol.12 (4), p.309-314 |
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| creator | YIP, C. C CHNG, N. W EONG, K. G. A. U HENG, W. J LIM, T. H LIM, W. K |
| description | To compare the efficacy of low-dose intravenous methylprednisolone or conservative treatment in the management of traumatic optic neuropathy.
A non-randomized retrospective study of 21 patients (21 eyes) with traumatic optic neuropathy treated between October 95 and November 97 in a tertiary ophthalmology unit. Traumatic optic neuropathy was defined as traumatic visual loss with afferent pupillary defect in the absence of direct injury to the globe or optic nerve. The median follow-up period was one year. Nine patients were treated with 125-250 mg methylprednisolone 6-hourly intravenously for a mean of 3.3 days (range 2-5 days) and 12 patients were treated conservatively. Visual acuity (VA) was measured with a Snellen chart before and after treatment at each follow-up visit. Visual recovery was defined as an improvement of 2 or more Snellen lines one week post-injury or later.
The patients' mean age was 37.1 years (range 12-65 years). There were more males (90.5%) than females (9.5%). Traumatic optic neuropathy was in 12 right eyes and 9 left eyes. The cause of injury included traffic accidents (52.4%), falls (28.6%), assault (14.2%) and others (4.8%). The mean interval between the injury and steroid therapy was 3.6 days (range 1-11 days). Visual recovery was observed in 44.4% of eyes treated with methylprednisolone and in 33.3% treated conservatively (p = 0.673, Fisher's exact test).
Intravenous methylprednisolone at the dosage and duration used in this retrospective study did not significantly improve the visual recovery of eyes with traumatic optic neuropathy compared to conservative treatment. However, this small sample may not be sensitive enough to detect a small difference in visual recovery rates, and further studies with larger samples may be warranted. |
| doi_str_mv | 10.1177/112067210201200410 |
| format | Article |
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A non-randomized retrospective study of 21 patients (21 eyes) with traumatic optic neuropathy treated between October 95 and November 97 in a tertiary ophthalmology unit. Traumatic optic neuropathy was defined as traumatic visual loss with afferent pupillary defect in the absence of direct injury to the globe or optic nerve. The median follow-up period was one year. Nine patients were treated with 125-250 mg methylprednisolone 6-hourly intravenously for a mean of 3.3 days (range 2-5 days) and 12 patients were treated conservatively. Visual acuity (VA) was measured with a Snellen chart before and after treatment at each follow-up visit. Visual recovery was defined as an improvement of 2 or more Snellen lines one week post-injury or later.
The patients' mean age was 37.1 years (range 12-65 years). There were more males (90.5%) than females (9.5%). Traumatic optic neuropathy was in 12 right eyes and 9 left eyes. The cause of injury included traffic accidents (52.4%), falls (28.6%), assault (14.2%) and others (4.8%). The mean interval between the injury and steroid therapy was 3.6 days (range 1-11 days). Visual recovery was observed in 44.4% of eyes treated with methylprednisolone and in 33.3% treated conservatively (p = 0.673, Fisher's exact test).
Intravenous methylprednisolone at the dosage and duration used in this retrospective study did not significantly improve the visual recovery of eyes with traumatic optic neuropathy compared to conservative treatment. However, this small sample may not be sensitive enough to detect a small difference in visual recovery rates, and further studies with larger samples may be warranted.</description><identifier>ISSN: 1120-6721</identifier><identifier>EISSN: 1724-6016</identifier><identifier>DOI: 10.1177/112067210201200410</identifier><identifier>PMID: 12220002</identifier><language>eng</language><publisher>Milano: Wichtig</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Child ; Eye Injuries - drug therapy ; Eye Injuries - etiology ; Eye Injuries - physiopathology ; Female ; Glucocorticoids - administration & dosage ; Humans ; Infusions, Intravenous ; Injuries of the orbit. Foreign bodies of the eye. Diseases due to physical agents ; Male ; Medical sciences ; Methylprednisolone - administration & dosage ; Middle Aged ; Optic Nerve Injuries - drug therapy ; Optic Nerve Injuries - etiology ; Optic Nerve Injuries - physiopathology ; Retrospective Studies ; Traumas. Diseases due to physical agents ; Treatment Outcome ; Visual Acuity - physiology</subject><ispartof>European journal of ophthalmology, 2002-07, Vol.12 (4), p.309-314</ispartof><rights>2002 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c329t-cb449d64c5fc510162a487dbdf512ab5c02b6ee392b0f06a4a3475959d9886983</citedby><cites>FETCH-LOGICAL-c329t-cb449d64c5fc510162a487dbdf512ab5c02b6ee392b0f06a4a3475959d9886983</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13918814$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12220002$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>YIP, C. C</creatorcontrib><creatorcontrib>CHNG, N. W</creatorcontrib><creatorcontrib>EONG, K. G. A. U</creatorcontrib><creatorcontrib>HENG, W. J</creatorcontrib><creatorcontrib>LIM, T. H</creatorcontrib><creatorcontrib>LIM, W. K</creatorcontrib><title>Low-dose intravenous methylprednisolone or conservative treatment in the management of traumatic optic neuropathy</title><title>European journal of ophthalmology</title><addtitle>Eur J Ophthalmol</addtitle><description>To compare the efficacy of low-dose intravenous methylprednisolone or conservative treatment in the management of traumatic optic neuropathy.
A non-randomized retrospective study of 21 patients (21 eyes) with traumatic optic neuropathy treated between October 95 and November 97 in a tertiary ophthalmology unit. Traumatic optic neuropathy was defined as traumatic visual loss with afferent pupillary defect in the absence of direct injury to the globe or optic nerve. The median follow-up period was one year. Nine patients were treated with 125-250 mg methylprednisolone 6-hourly intravenously for a mean of 3.3 days (range 2-5 days) and 12 patients were treated conservatively. Visual acuity (VA) was measured with a Snellen chart before and after treatment at each follow-up visit. Visual recovery was defined as an improvement of 2 or more Snellen lines one week post-injury or later.
The patients' mean age was 37.1 years (range 12-65 years). There were more males (90.5%) than females (9.5%). Traumatic optic neuropathy was in 12 right eyes and 9 left eyes. The cause of injury included traffic accidents (52.4%), falls (28.6%), assault (14.2%) and others (4.8%). The mean interval between the injury and steroid therapy was 3.6 days (range 1-11 days). Visual recovery was observed in 44.4% of eyes treated with methylprednisolone and in 33.3% treated conservatively (p = 0.673, Fisher's exact test).
Intravenous methylprednisolone at the dosage and duration used in this retrospective study did not significantly improve the visual recovery of eyes with traumatic optic neuropathy compared to conservative treatment. However, this small sample may not be sensitive enough to detect a small difference in visual recovery rates, and further studies with larger samples may be warranted.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Eye Injuries - drug therapy</subject><subject>Eye Injuries - etiology</subject><subject>Eye Injuries - physiopathology</subject><subject>Female</subject><subject>Glucocorticoids - administration & dosage</subject><subject>Humans</subject><subject>Infusions, Intravenous</subject><subject>Injuries of the orbit. Foreign bodies of the eye. Diseases due to physical agents</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methylprednisolone - administration & dosage</subject><subject>Middle Aged</subject><subject>Optic Nerve Injuries - drug therapy</subject><subject>Optic Nerve Injuries - etiology</subject><subject>Optic Nerve Injuries - physiopathology</subject><subject>Retrospective Studies</subject><subject>Traumas. Diseases due to physical agents</subject><subject>Treatment Outcome</subject><subject>Visual Acuity - physiology</subject><issn>1120-6721</issn><issn>1724-6016</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkMtOwzAQRS0EoqXwAyxQNrAL2I7z8BJVvKRKbGAdTZwJDUrs1HaK-ve4NFIXbGZGM-deaS4h14zeM5bnD4xxmuWcUU7DRAWjJ2TOci7ijLLsNMxhHe-JGblw7psGUAp-TmaM8yCgfE42K_MT18Zh1GpvYYvajC7q0a933WCx1q0zndEYGRspox3aLfh2i5G3CL5H7YMw8muMetDwhX8b04QzjH0gVWSGfdU4WjNAsL0kZw10Dq-mviCfz08fy9d49f7ytnxcxSrh0seqEkLWmVBpo1IW_uEgiryu6iZlHKpUUV5liInkFW1oBgISkacylbUsikwWyYLcHXwHazYjOl_2rVPYdaAx_FjmnOZJUtAA8gOorHHOYlMOtu3B7kpGy33Q5f-gg-hmch-rHuujZEo2ALcTAE5B11jQqnVHLpGsKJhIfgEICYdV</recordid><startdate>20020701</startdate><enddate>20020701</enddate><creator>YIP, C. C</creator><creator>CHNG, N. W</creator><creator>EONG, K. G. A. U</creator><creator>HENG, W. J</creator><creator>LIM, T. H</creator><creator>LIM, W. K</creator><general>Wichtig</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20020701</creationdate><title>Low-dose intravenous methylprednisolone or conservative treatment in the management of traumatic optic neuropathy</title><author>YIP, C. C ; CHNG, N. W ; EONG, K. G. A. U ; HENG, W. J ; LIM, T. H ; LIM, W. K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c329t-cb449d64c5fc510162a487dbdf512ab5c02b6ee392b0f06a4a3475959d9886983</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Eye Injuries - drug therapy</topic><topic>Eye Injuries - etiology</topic><topic>Eye Injuries - physiopathology</topic><topic>Female</topic><topic>Glucocorticoids - administration & dosage</topic><topic>Humans</topic><topic>Infusions, Intravenous</topic><topic>Injuries of the orbit. Foreign bodies of the eye. Diseases due to physical agents</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methylprednisolone - administration & dosage</topic><topic>Middle Aged</topic><topic>Optic Nerve Injuries - drug therapy</topic><topic>Optic Nerve Injuries - etiology</topic><topic>Optic Nerve Injuries - physiopathology</topic><topic>Retrospective Studies</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Treatment Outcome</topic><topic>Visual Acuity - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>YIP, C. C</creatorcontrib><creatorcontrib>CHNG, N. W</creatorcontrib><creatorcontrib>EONG, K. G. A. U</creatorcontrib><creatorcontrib>HENG, W. J</creatorcontrib><creatorcontrib>LIM, T. H</creatorcontrib><creatorcontrib>LIM, W. K</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>YIP, C. C</au><au>CHNG, N. W</au><au>EONG, K. G. A. U</au><au>HENG, W. J</au><au>LIM, T. H</au><au>LIM, W. K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Low-dose intravenous methylprednisolone or conservative treatment in the management of traumatic optic neuropathy</atitle><jtitle>European journal of ophthalmology</jtitle><addtitle>Eur J Ophthalmol</addtitle><date>2002-07-01</date><risdate>2002</risdate><volume>12</volume><issue>4</issue><spage>309</spage><epage>314</epage><pages>309-314</pages><issn>1120-6721</issn><eissn>1724-6016</eissn><abstract>To compare the efficacy of low-dose intravenous methylprednisolone or conservative treatment in the management of traumatic optic neuropathy.
A non-randomized retrospective study of 21 patients (21 eyes) with traumatic optic neuropathy treated between October 95 and November 97 in a tertiary ophthalmology unit. Traumatic optic neuropathy was defined as traumatic visual loss with afferent pupillary defect in the absence of direct injury to the globe or optic nerve. The median follow-up period was one year. Nine patients were treated with 125-250 mg methylprednisolone 6-hourly intravenously for a mean of 3.3 days (range 2-5 days) and 12 patients were treated conservatively. Visual acuity (VA) was measured with a Snellen chart before and after treatment at each follow-up visit. Visual recovery was defined as an improvement of 2 or more Snellen lines one week post-injury or later.
The patients' mean age was 37.1 years (range 12-65 years). There were more males (90.5%) than females (9.5%). Traumatic optic neuropathy was in 12 right eyes and 9 left eyes. The cause of injury included traffic accidents (52.4%), falls (28.6%), assault (14.2%) and others (4.8%). The mean interval between the injury and steroid therapy was 3.6 days (range 1-11 days). Visual recovery was observed in 44.4% of eyes treated with methylprednisolone and in 33.3% treated conservatively (p = 0.673, Fisher's exact test).
Intravenous methylprednisolone at the dosage and duration used in this retrospective study did not significantly improve the visual recovery of eyes with traumatic optic neuropathy compared to conservative treatment. However, this small sample may not be sensitive enough to detect a small difference in visual recovery rates, and further studies with larger samples may be warranted.</abstract><cop>Milano</cop><pub>Wichtig</pub><pmid>12220002</pmid><doi>10.1177/112067210201200410</doi><tpages>6</tpages></addata></record> |
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| ispartof | European journal of ophthalmology, 2002-07, Vol.12 (4), p.309-314 |
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| subjects | Adolescent Adult Aged Biological and medical sciences Child Eye Injuries - drug therapy Eye Injuries - etiology Eye Injuries - physiopathology Female Glucocorticoids - administration & dosage Humans Infusions, Intravenous Injuries of the orbit. Foreign bodies of the eye. Diseases due to physical agents Male Medical sciences Methylprednisolone - administration & dosage Middle Aged Optic Nerve Injuries - drug therapy Optic Nerve Injuries - etiology Optic Nerve Injuries - physiopathology Retrospective Studies Traumas. Diseases due to physical agents Treatment Outcome Visual Acuity - physiology |
| title | Low-dose intravenous methylprednisolone or conservative treatment in the management of traumatic optic neuropathy |
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