Abstract Objective To study the effect of large-dose glucocorticoid therapy in patients with traumatic optic neuropathy and to identify the major correlates in medical therapy that result in better visual function after trauma. Methods Twelve cases of patients with injured optical nerve diagnosed by computer-assisted tomography of the brain and eye received a combination therapy consisting of methylprednisolone (1000 mg intravenously, days 1-5) and mannitol (MINT) (250 mg intravenously, days 1-5). After 5 days, methylprednisolone was reduced to 800 mg/d, the therapy dose was reduced 200 mg every three days, when methylprednisolone was reduced to 200 mg/d, the therapy dose was reduced 50 mg every three days, when methylprednisolone was reduced to 50 mg/d, the therapy dose was reduced 5 mg everyday until to zero. Additional therapy included nerve growth factor. Results Thirty to 46 days after treatment, visual acuity was ≥0.15 in 9 cases, 0.06 in 1 case and 2 cases gained light perception. The 0.06 case lost light perception in the temporal visual field. No severe optic atrophy was found during long-term follow-up. Conclusion Patients who received a large dose of methylprednisolone and MNT shortly after traumatic optic neuropathy gained better visual acuity and optic atrophy was prevented.
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