Oral steroids provide clinically insignificant benefits in NAAION
Use of oral steroids in acute nonarteritic anterior ischaemic optic neuropathy (NAAION) does not lead to significant improvements in visual acuity at 6 months, but it significantly enhances resolution of disc oedema and allows greater progress in visual evoked response (VER) parameters, reports a recent study.
A total of 38 patients with acute nondiabetic NAAION were recruited in this randomized double-blind clinical trial that examined the role of oral steroid therapy in the treatment of such condition. Participants were divided into two arms of 19 patients each, with one arm constituting the cases and the other the controls.
NAAION patients received oral steroid therapy and were designated the steroid group, while control participants received placebo and were designated the nonsteroid group. The authors performed best-corrected visual acuity (BCVA), VER and optical coherence tomography (OCT) assessments at baseline, 1 month, 3 months and 6 months after recruitment into the trial.
There were significant improvements in BCVA, VER latency and resolution of disc oedema on OCT parameters over 6 months in both groups.
No statistically significant difference was observed in terms of visual acuity, but VER was better in the steroid group (p=0.011). The steroid group also had a greater percentage improvement in BCVA (p=0.02), VER amplitude (p=0.02) and VER latency (p=0.04), as well as a faster resolution of disc oedema on OCT at 1-month follow-up.
“This subtle benefit of oral steroids in NAAION is clinically unimportant and does not provide support for its use,” the authors said.