title: [Immunomodulation and neuroprotection in optic neuritis].
abstract: BACKGROUND
  To date, high-dose corticosteroids constitute the only established treatment of acute optic neuritis (ON); however, steroids cannot prevent the loss of retinal nerve fibers. New acute therapeutic drugs are therefore being sought for a reduction of ganglion cell death.
  
  
  METHODS
  Literature search comprising clinical studies on treatment of ON with immunomodulatory and neuroprotective drugs.
  
  
  RESULTS
  For the immunomodulatory drug simvastatin some evidence for long-term benefits was shown, particularly regarding visual evoked potentials. For the neuroprotective substance memantine a potential positive effect on retinal nerve fiber layer (RNFL) thickness was revealed. Likewise in one publication a reduction in loss of RNFL thickness could be demonstrated for erythropoietin and this drug is currently being extensively investigated in a phase III randomized controlled trial (RCT). The results of studies with phenytoin, amiloride and anti-leucine-rich repeat and immunoglobulin domain containing 1 protein (anti-LINGO-1) antibodies are awaiting publication.
  
  
  CONCLUSIONS
  According to the data from recent treatment trials, there is hope that neuronal loss in ON can be reduced with the help of immunomodulatory substances, such as simvastatin or neuroprotective agents, such as memantine and erythropoietin.
authors.affiliation: Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland. flemming.beisse@med.uni-heidelberg.de.
authors.forename: F
authors.initials: F
authors.lastname: Beisse
authors.affiliation: Neurologische Klinik, Universitätsklinikum Heidelberg, Heidelberg, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Diem
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000188:drug therapy* / Q000276:immunology; D019317:Evidence-Based Medicine; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage*; D056747:Immunomodulation; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D058990:Molecular Targeted Therapy / Q000379:methods; D018696:Neuroprotective Agents / Q000008:administration & dosage*; D009902:Optic Neuritis / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D018696:Neuroprotective Agents
keywords: Amiloride; Erythropoietin; LINGO-1 protein, human; Memantine; Phenytoin