Intravenous immunoglobulin in recurrent-relapsing inflammatory optic neuropathy

Hadas Stiebel-Kalish, Naama Hammel, Judith van Everdingen, Ruth Huna-Baron, Andrew G Lee

Research output: Contribution to journalArticleResearchpeer-review


OBJECTIVE: Recurrent-relapsing inflammatory optic neuropathy, including chronic relapsing inflammatory and autoimmune optic neuropathies, is rare, but can cause severe visual loss. Long-term steroids may preserve vision, yet side effects are frequent. We describe our experience with intravenous immunoglobulins (IVIg).

DESIGN: A semi-prospective case series from 4 medical centres.

PARTICIPANTS: Patients with steroid responsive recurrent-relapsing optic neuropathy.

METHODS: Semiprospective case series of IVIg treatment in steroid-responsive recurrent-relapsing optic neuropathy at 4 medical centres. Outcome measures included visual outcome; time to, and duration of, remission; duration of corticosteroid use; and adverse events.

RESULTS: Vision stabilized in all 6 patients treated with IVIg without steroids for extended periods of time. None improved and none worsened. One adverse event occurred during an IVIg infusion after 3 uneventful years of IVIg maintenance. Average steroid use prior to IVIg was 12 months. After IVIg treatment, 5/6 patients no longer required corticosteroids. Two patients experienced late relapses on IVIg, one of whom was treated with cyclosporine, the other with steroids.

CONCLUSIONS: IVIg can be considered an effective steroid-sparing agent in selected cases with steroid-dependent recurrent-relapsing autoimmune optic neuropathy.

Original languageEnglish
Pages (from-to)71-5
Number of pages5
JournalCanadian journal of ophthalmology. Journal canadien d'ophtalmologie
Issue number1
Publication statusPublished - Feb 2010


  • Adrenal Cortex Hormones/administration & dosage
  • Adult
  • Cyclosporine/therapeutic use
  • Female
  • Humans
  • Immunoglobulins, Intravenous/adverse effects
  • Male
  • Middle Aged
  • Optic Nerve Diseases/drug therapy
  • Prospective Studies
  • Recurrence
  • Treatment Outcome
  • Visual Acuity/drug effects
  • Visual Fields/drug effects


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