high dose intravenous corticosteroid versus placebo in recent traumatic optic neuropathy

purpose: to compare the effect of high dose intravenous corticosteroid therapy with placebo in the treatment of recent traumatic optic neuropathy (ton). methods: in a double masked-placebo controlled clinical trial, 31 eyes of 31 patients were randomly assigned into two groups. only patients with history of ophthalmic or head trauma within the past 7 days were included. unconscious patients, those with penetrating ocular injury, and candidates for decompression surgery were excluded. the treatment group (16 eyes) received 1 gr methylprednisolone intravenously for 3 days followed by 1 mg/kg prednisolone orally for 11 days. the placebo group (15 eyes) received 50 ml normal saline intravenously every 6 hours for 3 days. visual improvement was defined as increase of at least 0.3 logmar visual acuity after 3 months. results: visual improvement was achieved in 68.8% of the treatment group and 53.3% of the placebo group (p=0.1). visual improvement in the first 48 hours was correlated with final visual acuity (p=0.03) but final visual acuity was not significantly correlated with age (p=0.06), interval from trauma to treatment (p=0.5), and initial visual acuity (p=0.06). conclusion: in patients with recent ton, high-dose intravenous corticosteroids and placebo are comparable in terms of improvement in visual acuity.