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Pediatric Optic Neuritis: Does a Prolonged Course of Steroids Reduce Relapses? A Preliminary Study.
MedLine Citation:
PMID:  25152962     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Optic neuritis is an important pediatric disorder causing visual impairment. Because of the absence of pediatric-specific studies, data extrapolated from the adult-based optic neuritis treatment trial are used to guide management of pediatric patients. Recent literature promotes a prolonged course of oral steroids to prevent relapses. However, there are no published data to support this view. Patients who were recently treated in our hospital received a longer course of steroids, relative to those treated several years ago. We hypothesized that a longer course of steroids results in fewer relapses and better final visual acuity.
METHODS: A retrospective analysis of 26 consecutive patients (age 4.5-19 years) treated for optic neuritis within the past 10 years was conducted. Patients received either a short course (2 weeks) or a prolonged course (more than 2 weeks) of steroids. Some patients were not treated. Mean follow-up was 70 weeks (3 weeks-10 years). Comparisons were made among the groups receiving 2 weeks of steroid treatment (16 of 26 patients) and >2 weeks of steroid treatment (seven of 26 patients) to evaluate relapse rate, eventual visual acuity, and reported side effects.
RESULTS: There were no significant differences in the relapse rates, reported side effects, and final visual acuity in the two treatment groups.
CONCLUSIONS: In this cohort, a prolonged course of steroids was not associated with reduced relapse rate, increased side effects, or improved visual outcome. This cohort was small, but the results do not identify any reason to deviate from the common approach of optic neuritis treatment, which is 2 weeks of steroids.
Authors:
Himali Jayakody; Daniel J Bonthius; Reid Longmuir; Charuta Joshi
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-22
Journal Detail:
Title:  Pediatric neurology     Volume:  -     ISSN:  1873-5150     ISO Abbreviation:  Pediatr. Neurol.     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-8-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508183     Medline TA:  Pediatr Neurol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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