A Prospective Randomized Trial of Megadose Methyl prednisolone and High Dose Dexamethasone for Trau matic Optic Neuropathy
WANICHA CHUENKONGKAEW,M.D.*, NIPHON CHIRAPAPAISAN, M.D.*
Affiliation : *Department of Ophthalmology, Faculty or"Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Purpose : To determine whether the improvement in visual acuity obtained when using high dose dexamethasone in the treatment of traumatic optic neuropathy was comparable to that of megadose methylprednisolone.
Method : A total of forty-four patients with traumatic optic neuropathy were prospectively randomized and selected to receive intravenous high dose dexamethasone or megadose methylpredni solone within 2 weeks of injury. Age, gender, cause of injury, interval from injury to treatment, initial, post-pulse, and final visual acuity were analysed statistically to compare the dexamethasone and methylprednisolone groups.
Results : The mean interval to treatment was not significantly different (p=0.28) for the dexamethasone group at 5.5 days compared to the methylprednisolone group at 4.1 days. Visual improvement of at least two lines of the Snellen chart or two levels of unmeasured visual acuity was shown in 9 patients (37.5%) of the dexamethasone group and 10 patients (50%) of the methylpredni solone group. There was no statistically significant difference between the initial and post-pulse visual acuity (p=l.O) and the initial and final visual outcome (p=0.60) in the dexamethasone group com pared with the methylprednisolone group.
Conclusion : There was no significant difference in the visual acuity obtained after treat ment with intravenous dexamethasone or methylprednisolone for traumatic optic neuropath¥.
Keywords : Traumatic Optic Neuropathy, High Dose Dexamethasone, Megadose Methylprednisolone
