THE TUBINGEN STUDY ON OPTIC NEURITIS TREATMENT - A PROSPECTIVE, RANDOMIZED AND CONTROLLED TRIAL

This study was performed to examine whether an effect of oral predniso lone on acute optic neuritis (ON) of presumed demyelinative origin can be observed, when the course of the disease is assessed by new and se nsitive methods. The study started in 1980 and included the following parameters: kinetic and profile perimetry, visual acuity, visual evoke d potentials and Aulhorn flicker test, which monitors the activity of ON. The last two tests were used for the first time in a controlled tr eatment study. Fifty patients with acute, unilateral ON were treated o rally with either methylprednisolone (100, 80, 60, 40, 30, 20, 10, 5 m g/day-for 3 days each) or vitamin B1 (100 mg thiamin daily for 24 days ) in a randomized, prospective and controlled procedure, 38 of them do uble-blind- This paper presents the results of Tubingen manual perimet ry: kinetic and profile (light difference sensitivity) and relates the m to visual acuity and Aulhorn flicker test. Statistical evaluation (e vent time analysis) showed the same trend for all parameters: a slight ly faster recovery within the first weeks in prednisolone-treated pati ents compared to the control group-without statistical significance, a nd no significant difference after 12 months. From our results we conc lude that oral prednisolone treatment in this dosage has no long-term benefit and is an ineffective therapy. As ON shows a high tendency to spontaneous remission, steroid treatment should be reserved for severe cases, and then be applied i.v. in a high dose.