Rx May Improve Vision in Patients with Eye Condition

Fluocortolone treatment for nonarteritic anterior ischemic optic neuropathy found to improve vision compared to standard treatment alone

(RxWiki News) A team of researchers may have discovered a more effective treatment for patients with nonarteritic anterior ischemic optic neuropathy (NAION) — an eye condition that causes sudden and irreversible vision loss.

A recent study found that by adding fluocortolone to standard treatment for NAION, patients had improved visual acuity (clearness of vision) when compared to patients who only received Trental (pentoxifylline), the standard treatment for NAION.

These researchers also found that the positive effects of flucortolone on vision became greater over time.

"Speak with your doctor about treatment options for NAION."

This study was led by Verena Prokosch, PhD, of the Institute of Experimental Ophthalmology at Westfalische Wilhelms-Universitat in Germany. This research team compared the short- and long-term effects of fluocortolone treatment for NAION to the effects of standard treatment with pentoxifylline.

NAION is an eye condition that causes irreversible vision loss due to damage to the optic nerve, which connects the retina to the brain.

Fluocortolone is a corticosteroid (an anti-inflammatory medication), and pentoxifylline is a medication that is used to improve blood flow.

Dr. Prokosch and colleagues analyzed data from 60 NAION patients. These patients were randomly split into two groups: the fluocortolone treatment group and the standard treatment group.

Patients in the standard treatment group received 300 milligrams of pentoxifylline by injection and 1,200 milligrams orally for seven days. The oral treatment was then continued over the next six months.

Patients in the fluocortolone treatment group received the standard treatment in addition to a pre-determined dose of fluocortolone based on their body weight. This dose was reduced by 20 milligrams every five days.

Visual acuity was measured at the beginning of the study, three days after the treatment began and again at six months. Visual field was measured at the same time. Visual field is the total area in which objects can be seen through side vision as eyes are focused forward.

The researchers found that patients who received fluocortolone were more likely to have improved visual acuity than patients who only received the standard treatment. Visual acuity scores ranged from 0-1.  An improvement in visual acuity score by 0.1 was considered to be significant.

Among patients who received fluocortolone treatment, visual acuity increased by 0.21 units over the study period. At six months, the average visual acuity score for this group was 0.43.

Among patients who received the standard treatment only, visual acuity score decreased by 0.05 units over the study period. At six months, the average visual acuity score for this group was 0.28.

These researchers did not find a significant effect of fluocortolone on visual field.

The authors of this study noted that the standard treatment alone had no positive effect on visual acuity or visual field.

Based on their findings, these authors concluded that adding steroids to NAION treatment could improve visual acuity for NAION patients.

This study was published on November 19 in Restorative Neurology and Neuroscience.

The authors reported no competing interests.

Review Date: 
November 21, 2013