Intravitreal triamcinolone improves recovery of visual acuity in nonarteritic anterior ischemic optic neuropathy.
BACKGROUND
The visual outcome in untreated nonarteritic anterior ischemic optic neuropathy (NAION) is dismal. Because intravitreal triamcinolone (IVTA) has shown promise in improving edematous retinal disorders, a pilot trial of this therapy in NAION was considered reasonable.


METHODS
Four eyes of 4 patients with severe visual loss due to NAION were treated with 4 mg IVTA (study group). The control group consisted of 6 consecutive patients with NAION who received no treatment. Patients were evaluated by the visual acuity and visual field measurements of the Early Treatment Diabetic Retinopathy Study (ETDRS) and fluorescein angiography.


RESULTS
All patients completed at least 9 months of follow-up. In the study group, the mean improvement in visual acuity were 4, 5.8, and 6.2 ETDRS lines at the first and third weeks and final visit, respectively. Optic disc swelling and leakage had markedly decreased at the first postinjection week and had disappeared by the third week examination in all eyes. In the control group, the mean improvements in visual acuity were 0, 0.7, and 1.3 ETDRS lines at the first and third weeks and final visit, respectively. Control eyes showed resolution of the optic disc swelling between the fourth week and third month visits. No marked change in visual field defects was observed in either group.


CONCLUSIONS
IVTA provided relatively improved recovery of visual acuity and relatively rapid resolution of optic disc swelling in a small sample of patients with acute NAION. It did not provide visual field improvement. A larger trial is merited by the results of this small pilot study.
Kaderli
Berkant
B
Department of Ophthalmology, Uludag University School of Medicine, 16059 Gorukle Campus, Bursa, Turkey. kaderli@uludag.edu.tr
Avci
Remzi
R
Yucel
Ali
A
Guler
Kazim
K
Gelisken
Oner
O
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000098:blood supply / Q000187:drug effects / Q000503:physiopathology; D009900:Optic Nerve / Q000187:drug effects* / Q000503:physiopathology; D009902:Optic Neuritis / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control; D018917:Optic Neuropathy, Ischemic / Q000188:drug therapy* / Q000503:physiopathology; D010211:Papilledema / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control; D010865:Pilot Projects; D020127:Recovery of Function / Q000187:drug effects / Q000502:physiology; D012161:Retinal Artery / Q000187:drug effects / Q000503:physiopathology; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage*; D014792:Visual Acuity / Q000187:drug effects* / Q000502:physiology
D000893:Anti-Inflammatory Agents; D014221:Triamcinolone