J Med Assoc Thai 2002; 85 (5):597

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A Prospective Randomized Trial of Megadose Methylprednisolone and High Dose Dexamethasone for Traumatic Optic Neuropathy
Chuenkongkaew W Mail, Chirapapaisan N

WANICHA CHUENKONGKAEW,M.D.*,
NIPHON CHIRAPAPAISAN, M.D.*
Purpose : To determine whether the improvement in visual acuity obtained when using
high dose dexamethasone in the treatment of traumatic optic neuropathy was comparable to that of
megadose methylprednisolone.
Method : A total of forty-four patients with traumatic optic neuropathy were prospectively
randomized and selected to receive intravenous high dose dexamethasone or megadose methylpredni-
solone within 2 weeks of injury. Age, gender, cause of injury, interval from injury to treatment, initial,
post-pulse, and final visual acuity were analysed statistically to compare the dexamethasone and
methylprednisolone groups.
Results : The mean interval to treatment was not significantly different (p=0.28) for the
dexamethasone group at 5.5 days compared to the methylprednisolone group at 4.1 days. Visual
improvement of at least two lines of the Snellen chart or two levels of unmeasured visual acuity was
shown in 9 patients (37.5%) of the dexamethasone group and 10 patients (50%) of the methylpredni-
solone group. There was no statistically significant difference between the initial and post-pulse visual
acuity (p=l.O) and the initial and final visual outcome (p=0.60) in the dexamethasone group com-
pared with the methylprednisolone group.
Conclusion : There was no significant difference in the visual acuity obtained after treat-
ment with intravenous dexamethasone or methylprednisolone for traumatic optic neuropathเธ….
Key word :Traumatic Optic Neuropathy, High Dose Dexamethasone, Megadose Methylprednisolone

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