Dexamethasone, the poor man’s drug: an alternative to methylprednisolone in optic neuritis

Dr Sharmistha Behera; Dr Bidisha Mahapatra; Dr K.C. Tudu

Volume : VI, Issue : VII, July - 2017

Dexamethasone, the poor man’s drug: an alternative to methylprednisolone in optic neuritis

Dr Sharmistha Behera, Dr Bidisha Mahapatra, Dr K. C. Tudu

Abstract :

Aim: To assess the visual function outcome and response of intravenous dexamethasone in the treatment of optic neuritis in a tertiary health care centre.

Materials and Methods: Study included 30 patients of acute optic neuritis presenting within eight days of onset and with visual acuity less than 20/60 in the affected eye. Patients received intravenous dexamethasone 100 mg in 250 ml of 5% dextrose over 1–2 hours daily, for three consecutive days[7] . Parameters tested were pupillary reactions, visual acuity, fundus findings, color vision, contrast sensitivity and visual fields for all patients at presentation and follow–up over a period of 1 year and results compared with standard pattern of outcome already laid down by randomised controlled trials such as ONTT(Optic Neuritis Treatment Trial) which used intravenous methylprednisolone 250 mg/six–hourly for three days followed by oral prednisolone for 11 days for treatment of optic neuritis and proved its efficacy. Results: Improvement in visual acuity was statistically significant for distance on day 3 ( P =0.000434 ) and for near vision on day 3 ( P = 0.000045); improvement in color vision was statistically significant on day 3 ( P =0.000143) . Significant improvement in RAPD,contrast sensitivity and visual fields were seen by 1 month (p<0.05). No serious side effects were observed. At one year, 78.12% (25 out of 32) eyes had visual acuity ≥ 20/40. Conclusion: Intravenous dexamethasone is a cost effective alternative to methylprednisolone treatment for optic neuritis.