Clinical Ophthalmology (Jun 2021)
Comparison of the Structure and Function of the Retina and the Optic Nerve in Patients with a History of Multiple Sclerosis-Related Demyelinating Retrobulbar Optic Neuritis Treated and Not Treated with Systemic Steroid Therapy
Abstract
Barbara Nowacka, Wojciech Lubiński 2nd Department of Ophthalmology, Pomeranian Medical University, Szczecin, PolandCorrespondence: Wojciech Lubiński 2nd Department of Ophthalmology, Pomeranian Medical University, Powstańców Wlkp. 72, Szczecin, 70-111, PolandTel +48 91 466 12 93Email [email protected]: To compare the structure and function of the retina and the optic nerve in patients with a history of multiple sclerosis (MS)-related demyelinating retrobulbar optic neuritis treated and not treated with systemic steroid therapy.Patients and Methods: Thirty-two eyes of 32 MS patients with a past single episode of MS-related demyelinating retrobulbar ON were divided into 2 groups: S(+) consisting of 16 patients treated with intravenous methylprednisolone at a dose of 1g/day for 3 days during the acute stage of ON and S(-) consisting of 16 patients who did not receive any treatment. The following examinations were performed: distance best-corrected visual acuity (DBCVA) (Snellen), slit-lamp examination of the anterior and posterior segment of the eye (90D Volk lens), visual field analysis (Carl Zeiss Humphrey 750 Visual Field Analyzer, 24-2, W-W), macular thickness in the foveal (RT1) and parafoveal region (RT2), as well as peripapillary retinal nerve fiber layer thickness (RNFL) in the temporal, superior, nasal and inferior quadrants (Carl Zeiss Cirrus HD-OCT), assessment of the bioelectrical function of the visual pathway with an emphasis on the optic nerve – pattern visual evoked potentials (PVEP) and of macular ganglion cells and cone photoreceptors – pattern electroretinogram (PERG) (Roland Consult).Results: No statistically significant differences were observed between the investigated groups in terms of DBCVA, mean deviation of visual field macular (RT1, RT2) and RNFL thickness in the temporal, superior, nasal and inferior quadrants, as well as of the bioelectrical function (PVEP, PERG).Conclusion: The application of steroid therapy should be considered on an individual basis and not as a routine treatment for each patient.Keywords: demyelinating optic neuritis, multiple sclerosis, steroids, perimetry, OCT, PERG, PVEP
