title: Comparative evaluation of megadose methylprednisolone with dexamethasone for treatment of primary typical optic neuritis.
abstract: OBJECTIVE
  To compare the efficacy of intravenous methylprednisolone and intravenous dexamethasone on visual recovery and evaluate their side-effects for the treatment of optic neuritis.
  
  
  METHODS
  Prospective, randomized case-controlled study including 21 patients of acute optic neuritis presenting within eight days of onset and with visual acuity less then 20/60 in the affected eye who were randomly divided into two groups. Group I received intravenous dexamethasone 200 mg once daily for three days and Group II received intravenous methylprednisolone 250 mg/six-hourly for three days followed by oral prednisolone for 11 days. Parameters tested were pupillary reactions, visual acuity, fundus findings, color vision, contrast sensitivity, Goldmann visual fields and biochemical investigations for all patients at presentation and follow-up.
  
  
  RESULTS
  Both groups were age and sex-matched. LOGMAR visual acuity at presentation was 1.10 +/- 0.52 in Group I and 1.52 +/- 0.43 in Group II. On day 90 of steroid therapy, visual acuity improved to 0.28 +/- 0.33 in Group I and 0.36 +/- 0.41 in Group II ( P =0.59). At three months there was no statistically significant difference in the color vision, contrast sensitivity, stereoacuity, Goldman fields and the amplitude and latency of visually evoked response between the two groups. The concentration of vitamin C, glucose, sodium, potassium, urea and creatinine were within the reported normal limits.
  
  
  CONCLUSIONS
  Intravenous dexamethasone is an effective treatment for optic neuritis. However, larger studies are required to establish it as a safe, inexpensive and effective modality for the treatment of optic neuritis.
authors: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors: Vimala
authors: V
authors: Menon
authors: Abhas
authors: A
authors: Mehrotra
authors: Rohit
authors: R
authors: Saxena
authors: Nargis F
authors: NF
authors: Jaffery
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D003118:Color Perception / Q000502:physiology; D003907:Dexamethasone / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000008:administration & dosage*; D009887:Ophthalmoscopy; D009902:Optic Neuritis / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D011446:Prospective Studies; D020127:Recovery of Function; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology
chemical_list: D005938:Glucocorticoids; D018696:Neuroprotective Agents; D003907:Dexamethasone; D008775:Methylprednisolone
references: Indian J Pediatr. 1998 Jul-Aug;65(4):557-60
references: 10773904
references: J Neurol. 2000 Jun;247(6):435-42
references: 10929272
references: Ann Dermatol Venereol. 2001 Mar;128(3 Pt 1):241-3
references: 11319388
references: J Neurosurg. 1983 Mar;58(3):326-30
references: 6338164
references: Br J Dermatol. 1988 Jul;119(1):73-7
references: 3408666
references: Am J Ophthalmol. 1990 Dec 15;110(6):665-9
references: 2248332
references: Indian J Ophthalmol. 2006 Sep;54(3):177-83
references: 16921215
references: JAMA. 1993 Apr 28;269(16):2110-2
references: 8468765
references: Control Clin Trials. 1993 Apr;14(2):123-42
references: 8500302
references: Arch Ophthalmol. 1994 Jan;112(1):35-6
references: 8285889
references: Eur Neurol. 1994;34(4):199-203
references: 7915989
references: Arch Ophthalmol. 1995 Feb;113(2):136-7
references: 7864737
references: Nippon Ganka Gakkai Zasshi. 1996 May;100(5):381-7
references: 8651057
references: Arch Ophthalmol. 1991 Dec;109(12):1673-8
references: 1841573