J Korean Ophthalmol Soc > Volume 58(10); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(10):1176-1182.
DOI: https://doi.org/10.3341/jkos.2017.58.10.1176    Published online October 15, 2017.
Therapeutic Effect of Steroids in Patients with Non-arteritic Anterior Ischemic Optic Neuropathy.
Jun Soo Eun, Myung Won Lee, Sung Eun Kyung
Department of Ophthalmology, Dankook University College of Medicine, Cheonan, Korea. kseeye@hanmail.net
비동맥염성 앞허혈시신경병증 환자에서 스테로이드 치료효과
은준수⋅이명원⋅경성은
단국대학교 의과대학 안과학교실
Correspondence:  Sung Eun Kyung,
Email: kseeye@hanmail.net
Received: 30 March 2017   • Revised: 29 August 2017   • Accepted: 20 September 2017
Abstract
PURPOSE
To investigate the effect of steroid treatment (intravenous injection, oral) in patients with non-arteritic anterior ischemic optic neuropathy (NAION). METHODS: From January, 2005 to December, 2016, 41 patients who were diagnosed with NAION and observed for more than 6 months were included in this study. The treatment was decided based on patient's choice after explaining the advantages and disadvantages of steroid therapy. The patients were divided into three groups (intravenous steroid injection, oral steroid, no treatment). Initial visual acuity, final visual acuity, degree of visual field defect, fluorescein angiography, visual evoked potential and brain magnetic resonance imaging were analyzed by chart review. RESULTS: The chief complaints of the 41 NAION patients at the first visit were decreased visual acuity (n = 24), visual field defect (n = 10), no symptoms (n = 4), diplopia (n = 2), and floaters (n = 1). The distribution of the patients according to steroid administration method was 15 patients with intravenous steroid injection, 14 patients with oral steroid and 12 patients with no treatment. The improvement in visual acuity was greatest in intravenous steroid injection (87%), oral steroid (43%) and no treatment (33%) in that order. CONCLUSIONS: In a retrospective comparison of treatment effects after explaining the advantages and disadvantages of steroid therapy in patients with NAION, the intravenous steroid injection group showed 87% improvement in visual acuity and an odds ratio of 5.5 (95% confidence interval [CI] 1.05–28.88, p-value 0.04), while the oral steroid group showed 43% improvement and an odds ratio of 1.5 (95% CI 0.30–7.43, p-value 0.62). The steroid treatment group showed better visual acuity improvement than the no treatment group, and the intravenous steroid injection group showed 5.5 times greater improvement in visual acuity compared to the no treatment group.
Key Words: Non-arteritic anterior ischemic optic neuropathy;Steroid;Visual field


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