Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Research Article Volume 6 Issue 10

Steroids for Optic Neuritis. Comparison between IV Steroids and Oral Steroids: Systematic Review and Meta-Analysis

Ahmad Sawalha1* and Huda Alkilani2

1Assistant Professor of Medicine. Philadelphia College of Medicine, Philadelphia, USA
2University of Sharjah, UAE

*Corresponding Author: Ahmad Sawalh, Assistant Professor of Medicine. Philadelphia College of Medicine, Philadelphia, USA.

Received: September 04, 2023; Published: September 26, 2023

Abstract

Introduction: Optic neuritis is defined as an inflammation of the optic nerve. It usually manifests with abrupt painful loss of vision. The recovery of the vision loss is almost never complete. Women are usually more commonly affected than men. Optic neuritis is most commonly due to autoimmune etiology and is closely linked to multiple sclerosis however, other etiologies including infectious do exist. Few trials evaluated the effectiveness of corticosteroids for the treatment of optic neuritis and rarely those trials compared between oral and intravenous corticosteroids use.

Search Methods: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2023), MEDLINE (January 1950 to July 2023, EMBASE (January 1980 to July 2023), PubMed (January 1946 to July 2023), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). No date or language restrictions in the electronic searches for trials were there. The electronic databases were last searched in July 2023. Selection criteria: We followed the PRISMA statement guidelines during the preparation of this systematic review. We included randomized controlled trials (RCTs) that evaluated intravenous corticosteroids in patients with acute optic neuritis in comparison to oral corticosteroids.

Main results: We included two RCTs with a total of 750 participants. Each trial was conducted in a different country: United States and Canada. The two trials included have low risk of bias. Both of those trials included information about the efficacy of IV steroids and oral steroids in improving visual acuity which allowed for comparison and further analysis. In the meta-analyses to assess visual acuity, the risk ratio (RR) was 0.98 (95% confidence interval (CI) 0.93 to 1.02) at six months.

Authors' conclusions: There is no conclusive evidence of difference in benefit in terms of recovery to normal visual acuity after six months of treatment with either intravenous or oral corticosteroids at the doses evaluated in trials included in this review.

Keywords: Steroids; Methylprednisolone; Prednisone; Optic Neuritis; Multiple Sclerosis

References

  1. Gal RL., et al. “Corticosteroids for treating optic neuritis”. Cochrane Database of Systematic Reviews 8 (2015): CD001430.
  2. Percy AK., et al. “Optic neuritis and multiple sclerosis. An epidemiologic study”. Archives of Ophthalmology 2 (1972): 135-139.
  3. Rodriguez M., et al. “Optic neuritis: a population-based study in Olmsted County, Minnesota”. Neurology 2 (1995): 244-250.
  4. Ebers GC. “Optic neuritis and multiple sclerosis”. Archives of Neurology 7 (1985): 702-704.
  5. Lightman S., et al. “Retinal venous sheathing in optic neuritis. Its significance for the pathogenesis of multiple sclerosis”. BrainPt 2 (1987): 405-414.
  6. Beck RW., et al. “A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group”. The New England Journal of Medicine 9 (1992): 581-588.
  7. Morrow SA., et al. “Effect of Treating Acute Optic Neuritis With Bioequivalent Oral vs Intravenous Corticosteroids: A Randomized Clinical Trial”. JAMA Neurology 6 (2018): 690-696.

Citation

Citation: Ahmad Sawalha and Huda Alkilani., et al. “Steroids for Optic Neuritis. Comparison between IV Steroids and Oral Steroids: Systematic Review and Meta-Analysis". Acta Scientific Neurology 6.10 (2023): 25-29.

Copyright

Copyright: © 2023 Ahmad Sawalha and Huda Alkilani., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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