Der Ophthalmologe

, Volume 104, Issue 6, pp 517–520

Steroide bei Sehnerverkrankungen?

Das therapeutische Prinzip
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Zusammenfassung

Erkrankungen des Sehnervs sind in Deutschland die dritthäufigste Erblindungsursache. Häufige Sehnerverkrankungen sind u. a. die Neuritis nervi optici und die traumatische Optikusneuropathie. Diese Erkrankungen werden häufig mit Steroiden behandelt. Bei der Behandlung der traumatischen Optikusneuropathie muss entsprechend neuerer Erkenntnisse davon ausgegangen werden, dass Steroide nicht von Nutzen sind und in sehr hoher Dosis bezüglich allgemeiner Nebenwirkungen sogar als gefährlich einzustufen sind. Ebenso ist bei Neuritis nervi optici der Nutzen hoch dosierter Steroide aufgrund aktueller Ergebnisse fraglich.

Schlüsselwörter

Neuritis nervi optici Traumatische Optikusneuropathie Steroide 

Steroids for optic nerve diseases?

Abstract

Diseases of the optic nerve are the third most common cause of blindness in Germany. Common optic nerve diseases include optic nerve neuritis and traumatic optic neuropathy. These diseases are often treated with steroids. In the case of traumatic optic neuropathy, recent results indicate that such treatment is not of value, and can even be dangerous due to the side effects if the doses are high. Based on current results, the value of high dose steroid treatment for optic nerve neuritis is also questionable.

Keywords

Optic nerve neuritis Traumatic optic neuropathy (TON) Steroids 

Literatur

  1. 1.
    Optic Neuritis Study Group (1997) The 5-year risk of MS after optic neuritis. Experience of the optic neuritis treatment trial. Neurology 49: 1404–1413PubMedGoogle Scholar
  2. 2.
    Auphan N, DiDonato JA, Rosette C et al. (1995) Immunosuppression by glucocorticoids: inhibition of NF-kappa B activity through induction of I kappa B synthesis. Science 270: 286–290PubMedGoogle Scholar
  3. 3.
    Beck RW, Cleary PA, Anderson MM Jr et al. (1992) A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med 326: 581–588PubMedGoogle Scholar
  4. 4.
    Beck RW, Gal RL, Bhatti MT et al. (2004) Visual function more than 10 years after optic neuritis: experience of the optic neuritis treatment trial. Am J Ophthalmol 137: 77–83CrossRefPubMedGoogle Scholar
  5. 5.
    Bracken MB, Shepard MJ, Collins WF et al. (1990) A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. Results of the Second National Acute Spinal Cord Injury Study. N Engl J Med 322: 1405–1411PubMedGoogle Scholar
  6. 6.
    Bracken MB, Shepard MJ, Holford TR et al. (1997) Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury. Results of the Third National Acute Spinal Cord Injury Randomized Controlled Trial. National Acute Spinal Cord Injury Study. JAMA 277: 1597–1604CrossRefPubMedGoogle Scholar
  7. 7.
    Buttgereit F, Wehling M, Burmester GR (1998) A new hypothesis of modular glucocorticoid actions: steroid treatment of rheumatic diseases revisited. Arthritis Rheum 41: 761–767PubMedGoogle Scholar
  8. 8.
    Diem R, Hobom M, Maier K et al. (2003) Methylprednisolone increases neuronal apoptosis during autoimmune CNS inflammation by inhibition of an endogenous neuroprotective pathway. J Neurosci 23: 6993–7000PubMedGoogle Scholar
  9. 9.
    Elovaara I, Ukkonen M, Leppakynnas M et al. (2000) Adhesion molecules in multiple sclerosis: relation to subtypes of disease and methylprednisolone therapy. Arch Neurol 57: 546–551PubMedGoogle Scholar
  10. 10.
    Falkenstein E, Tillmann HC, Christ M et al. (2000) Multiple actions of steroid hormones–a focus on rapid, nongenomic effects. Pharmacol Rev 52: 513–556PubMedGoogle Scholar
  11. 11.
    Frohman E, Costello F, Zivadinov R et al. (2006) Optical coherence tomography in multiple sclerosis. Lancet Neurol 5: 853–863PubMedGoogle Scholar
  12. 12.
    Gelati M, Corsini E, De Rossi M et al. (2002) Methylprednisolone acts on peripheral blood mononuclear cells and endothelium in inhibiting migration phenomena in patients with multiple sclerosis. Arch Neurol 59: 774–780PubMedGoogle Scholar
  13. 13.
    Gold R, Buttgereit F, Toyka KV (2001) Mechanism of action of glucocorticosteroid hormones: possible implications for therapy of neuroimmunological disorders. J Neuroimmunol 117: 1–8PubMedGoogle Scholar
  14. 14.
    Gould ES, Bird AC, Leaver PK, McDonald WI (1977) Treatmenf of optic neuritis by retrobulbar injection of triamcinolone. Br Med J 1: 1495–1497PubMedGoogle Scholar
  15. 15.
    Hickman SJ, Kapoor R, Jones SJ et al. (2003) Corticosteroids do not prevent optic nerve atrophy following optic neuritis. J Neurol Neurosurg Psychiatry 74: 1139–1141CrossRefPubMedGoogle Scholar
  16. 16.
    Joyce DA, Steer JH, Abraham LJ (1997) Glucocorticoid modulation of human monocyte/macrophage function: control of TNF-alpha secretion. Inflamm Res 46: 447–451PubMedGoogle Scholar
  17. 17.
    Kapoor R, Miller DH, Jones SJ et al. (1998) Effects of intravenous methylprednisolone on outcome in MRI-based prognostic subgroups in acute optic neuritis. Neurology 50: 230–237PubMedGoogle Scholar
  18. 18.
    Kappos L, Antel J, Comi G et al. (2006) Oral fingolimod (FTY720) for relapsing multiple sclerosis. N Engl J Med 355: 1124–1140CrossRefPubMedGoogle Scholar
  19. 19.
    Levin LA, Beck RW, Joseph MP et al. (1999) The treatment of traumatic optic neuropathy: the International Optic Nerve Trauma Study. Ophthalmology 106: 1268–1277CrossRefPubMedGoogle Scholar
  20. 20.
    Mangelsdorf DJ, Thummel C, Beato M et al. (1995) The nuclear receptor superfamily: the second decade. Cell 83: 835–839CrossRefPubMedGoogle Scholar
  21. 21.
    McDonald WI, Compston A, Edan G et al. (2001) Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol 50: 121–127CrossRefPubMedGoogle Scholar
  22. 22.
    Ohlsson M, Mattsson P, Svensson M (2004) A temporal study of axonal degeneration and glial scar formation following a standardized crush injury of the optic nerve in the adult rat. Restor Neurol Neurosci 22: 1–10PubMedGoogle Scholar
  23. 23.
    Ohlsson M, Westerlund U, Langmoen IA, Svensson M (2004) Methylprednisolone treatment does not influence axonal regeneration or degeneration following optic nerve injury in the adult rat. J Neuroophthalmol 24: 11–18PubMedGoogle Scholar
  24. 24.
    Polman CH, Reingold SC, Edan G et al. (2005) Diagnostic criteria for multiple sclerosis: 2005 revisions to the „McDonald Criteria“. Ann Neurol 58: 840–846CrossRefPubMedGoogle Scholar
  25. 25.
    Reagan LP, McEwen BS (1997) Controversies surrounding glucocorticoid-mediated cell death in the hippocampus. J Chem Neuroanat 13: 149–167PubMedGoogle Scholar
  26. 26.
    Rhen T, Cidlowski JA (2005) Antiinflammatory action of glucocorticoids–new mechanisms for old drugs. N Engl J Med 353: 1711–1723PubMedGoogle Scholar
  27. 27.
    Roberts I, Yates D, Sandercock P et al. (2004) Effect of intravenous corticosteroids on death within 14 days in 10008 adults with clinically significant head injury (MRC CRASH trial): randomised placebo-controlled trial. Lancet 364: 1321–1328CrossRefPubMedGoogle Scholar
  28. 28.
    Sapolsky RM (2000) Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders. Arch Gen Psychiatry 57: 925–935PubMedGoogle Scholar
  29. 29.
    Scheinman RI, Cogswell PC, Lofquist AK, Baldwin AS Jr (1995) Role of transcriptional activation of I kappa B alpha in mediation of immunosuppression by glucocorticoids. Science 270: 283–286PubMedGoogle Scholar
  30. 30.
    Schmidt J, Gold R, Schonrock L et al. (2000) T-cell apoptosis in situ in experimental autoimmune encephalomyelitis following methylprednisolone pulse therapy. Brain 123: 1431–1441PubMedGoogle Scholar
  31. 31.
    Sellebjerg F, Nielsen HS, Frederiksen JL, Olesen J (1999) A randomized, controlled trial of oral high-dose methylprednisolone in acute optic neuritis. Neurology 52: 1479–1484PubMedGoogle Scholar
  32. 32.
    Sheng Y, Zhu Y, Wu L (2004) Effect of high dosage of methylprednisolone on rat retinal ganglion cell apoptosis after optic nerve crush. Yan Ke Xue Bao 20: 181–186PubMedGoogle Scholar
  33. 33.
    Steel DH, Waldock A (1998) Measurement of the retinal nerve fibre layer with scanning laser polarimetry in patients with previous demyelinating optic neuritis. J Neurol Neurosurg Psychiatry 64: 505–509PubMedGoogle Scholar
  34. 34.
    Steinsapir KD (2006) Treatment of traumatic optic neuropathy with high-dose corticosteroid. J Neuroophthalmol 26: 65–67PubMedGoogle Scholar
  35. 35.
    Steinsapir KD, Goldberg RA, Sinha S, Hovda DA (2000) Methylprednisolone exacerbates axonal loss following optic nerve trauma in rats. Restor Neurol Neurosci 17: 157–163PubMedGoogle Scholar
  36. 36.
    Trapp BD, Peterson J, Ransohoff RM et al. (1998) Axonal transection in the lesions of multiple sclerosis. N Engl J Med 338: 278–285PubMedGoogle Scholar
  37. 37.
    Trautner C, Haastert B, Richter B et al. (2003) Incidence of blindness in southern Germany due to glaucoma and degenerative conditions. Invest Ophthalmol Vis Sci 44: 1031–1034CrossRefPubMedGoogle Scholar
  38. 38.
    Trauzettel-Klosinski S, Diener HC, Dietz K, Zrenner E (1995) The effect of oral prednisolone on visual evoked potential latencies in acute optic neuritis monitored in a prospective, randomized, controlled study. Doc Ophthalmol 91: 165–179PubMedGoogle Scholar
  39. 39.
    Trip SA, Schlottmann PG, Jones SJ et al. (2005) Retinal nerve fiber layer axonal loss and visual dysfunction in optic neuritis. Ann Neurol 58: 383–391PubMedGoogle Scholar
  40. 40.
    Trip SA, Schlottmann PG, Jones SJ et al. (2006) Quantification of optic nerve head topography in optic neuritis: a pilot study. Br J Ophthalmol 90: 1128–1131PubMedGoogle Scholar
  41. 41.
    Vedula S, Brodney-Folse S, Gal R, Beck R (2007) Corticosteroids for treating optic neuritis. Cochrane database of systematic reviews. (Online): CD001430Google Scholar
  42. 42.
    Wakakura M, Mashimo K, Oono S et al. (1999) Multicenter clinical trial for evaluating methylprednisolone pulse treatment of idiopathic optic neuritis in Japan. Optic Neuritis Treatment Trial Multicenter Cooperative Research Group (ONMRG). Jpn J Ophthalmol 43: 133–138PubMedGoogle Scholar
  43. 43.
    Watters JJ, Campbell JS, Cunningham MJ et al. (1997) Rapid membrane effects of steroids in neuroblastoma cells: effects of estrogen on mitogen activated protein kinase signalling cascade and c-fos immediate early gene transcription. Endocrinology 138: 4030–4033PubMedGoogle Scholar
  44. 44.
    Yip CC, Chng NW, Au Eong KG et al. (2002) Low-dose intravenous methylprednisolone or conservative treatment in the management of traumatic optic neuropathy. Eur J Ophthalmol 12: 309–314PubMedGoogle Scholar
  45. 45.
    Yudt MR, Cidlowski JA (2002) The glucocorticoid receptor: coding a diversity of proteins and responses through a single gene. Mol Endocrinol 16: 1719–1726PubMedGoogle Scholar
  46. 46.
    Zipp F, Wendling U, Beyer M et al. (2000) Dual effect of glucocorticoids on apoptosis of human autoreactive and foreign antigen-specific T cells. J Neuroimmunol 110: 214–222PubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag 2007

Authors and Affiliations

  1. 1.Universitäts-Augenklinik FreiburgFreiburgDeutschland

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