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.
|Number of pages||5|
|Journal||Canadian journal of ophthalmology. Journal canadien d'ophtalmologie|
|Publication status||Published - Feb 2010|
- Adrenal Cortex Hormones/administration & dosage
- Cyclosporine/therapeutic use
- Immunoglobulins, Intravenous/adverse effects
- Middle Aged
- Optic Nerve Diseases/drug therapy
- Prospective Studies
- Treatment Outcome
- Visual Acuity/drug effects
- Visual Fields/drug effects