Background The objective of this prospective pilot study was to evaluate the results of systemic
corticosteroid therapy in patient with non-arteritic anterior ischaemic neuropathy of the optical nerve (
NAION) for an observation period of one year and to measure the
NAION incidence in the initially healthy contralateral eye of these patients. Patients and Methods All patients diagnosed with acute
NAION who were admitted to our ward during 2014 and who fulfilled all inclusion criteria for systemic
corticosteroid therapy were included in the study. The inclusion criteria were corrected visual acuity of 0.3 or less and duration of illness of less than 2 weeks. All patients were examined by a rheumatologist and given a complete ophthalmological examination, including
fluorescein angiography and examination of the visual field. Only 3 of the 23 patients fulfilled our inclusion criteria for
corticoid treatment and were then treated. 10 patients served as controls. The treatment plan started with an initial dose of 80 mg
prednisolone during the first two weeks. The dose was then tapered over 3 to 4 months. Results The mean best corrected visual acuity on admission was 0.12 and 0.35 after one year. The mean
duration of treatment was 3.3 months. Treatment was discontinued after 5 to 6 months or 8 to 9 months after the initial examination. All patients then developed
NAION on the contralateral eye. The mean visual acuity on the contralateral eye was 0.73. After 4 month follow-up, the visual acuity in two patients had decreased to 1.0 and in one patient was reduced from 0.8 to 0.4. No
steroid treatment was initiated for the contralateral eye. No
NAION was found in the contralateral eye in the control group. Conclusion
Corticosteroid treatment improved vision in all patients with
NAION in comparison with the untreated contralateral eye. In a single patient, visual acuity decreased in the contralateral eye. Our study confirmed that
corticosteroid treatment may be a predisposing factor for the development of
NAION am in the contralateral eye. Additional studies with more patients are needed to confirm our results.