M. Wakakura et al., Multicenter clinical trial for evaluating methylprednisolone pulse treatment of idiopathic optic neuritis in Japan, JPN J OPHTH, 43(2), 1999, pp. 133-138
Background: A randomized, controlled clinical trial was conducted in 1991 t
o compare an intravenous megadose of methylprednisolone with a control drug
(mecobalamin) for treating acute idiopathic optic neuritis.
Cases: Sixty-six cases from 22 clinical centers throughout Japan were exami
ned to evaluate the treatment on visual function parameters, such as visual
acuity, visual field, color vision, contrast sensitivity, and critical fli
cker frequency.
Observations: The methylprednisolone pulse treatment group showed faster re
covery of visual function, particularly the visual acuity at 1 week (P < .0
5), Humphrey field analyzer mean deviation at 3 weeks (P < .05), and color
vision at 1 week (P < .05). Recovery of contrast sensitivity at several dif
ferent spatial frequencies was significant In the pulse treatment group at
1 (P < .01), 2 (P < .05), and 4 weeks (P < .05) after the start of treatmen
t. Visual function test results at 12 weeks and 1 year were essentially the
same in the two treatment groups. Side effects appeared more frequently in
the purse treatment group than in the control (P < .05).
Conclusions: Pulse treatment does not appear effective for idiopathic optic
neuritis even though Visual function in the pulse treatment group of this
trial recovered more quickly during the initial phase compared to the contr
ols. More effective and specific treatment should be established for optic
neuritis. (C) 1999 Japanese Ophthalmological Society.