IV corticosteroids may not improve vision in NAION

This retrospective study found that intravenous corticosteroids may not improve visual outcomes in non-arteritic anterior ischemic optic neuropathy (NAION) patients.

The use of steroids for NAION has been controversial. Some argue that faster resolution of optic disc edema with steroid treatment may lead to better visual outcomes. No prospective randomized studies have evaluated steroid use in the acute management of vision loss in NAION.

The authors examined whether treatment of NAION with steroids within 14 days of onset of vision loss led to any change in visual outcome. There were 23 patients (24 eyes) each in the control and treatment groups.

At six months’ follow up, there was no change in visual outcome in either group. Since intravenous steroids could potentially cause serious adverse side effects, the authors question their use in NAION. They write that they have abandoned the use of IV corticosteroids for NAION patients at their center until a randomized controlled trial proves their benefit.