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The effect of systemic erythropoietin and oral prednisolone on recent-onset non-arteritic anterior ischemic optic neuropathy: a randomized clinical trial

  • Neurophthalmology
  • Published:
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Abstract

Background

To evaluate the effect of systemic erythropoietin, as well as oral steroids, in the management of recent-onset non-arteritic anterior ischemic optic neuropathy (NAION).

Method

Patients diagnosed with NAION within 5 days were randomized into group A (systemic erythropoietin), group B (oral steroids), and group C (control). Group A received 10,000 units of erythropoietin twice a day for 3 days. Group B received oral prednisone 75 mg daily tapered off in 6 weeks.

Results

The mean best-corrected visual acuity (± SD) at the time of presentation was 1 ± 0.56, 1.01 ± 0.6, and 0.94 ± 0.47 logMAR in groups A, B, and C, respectively (P = 0.140); corresponding values at 6-month follow-up were 0.70 ± 0.44, 0.73 ± 0.35, and 0.75 ± 0.39 logMAR, respectively (P = 0.597). Fifty-five percent of patients in group A versus 34.3% in group B and 31.2% in group C had an improvement of at least 3 lines in the best-corrected visual acuity values at the 6th month of follow-up visit (P = 0.04). Peripapillary retinal nerve fiber layers at presentation were 189 ± 58, 193 ± 64, and 199 ± 62 micrometers, respectively (P = 0.779), which decreased to 88 ± 12, 74 ± 25, and 71 ± 18, respectively at 6-month follow-up (P = 0.041).

Conclusion

The findings of our study indicate the beneficial effects of systemic erythropoietin in preserving the function and structure of the optic nerve in recent-onset NAION.

Trial registration

Clinical registration number: IR.SBMU.ORC.REC.1397.18

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Authors and Affiliations

  1. Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Homayoun Nikkhah, Mahya Golalipour, Azadeh Doozandeh & Mohammad Pakravan

  2. Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mohammad Pakravan

  3. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Mehdi Yaseri

  4. Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, USA

    Hamed Esfandiari

  5. Division of Ophthalmology, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E. Chicago Ave., Chicago, Illinois, 60611, USA

    Hamed Esfandiari

Authors
  1. Homayoun Nikkhah
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  2. Mahya Golalipour
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  3. Azadeh Doozandeh
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  4. Mohammad Pakravan
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  5. Mehdi Yaseri
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  6. Hamed Esfandiari
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Correspondence to Hamed Esfandiari.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Nikkhah, H., Golalipour, M., Doozandeh, A. et al. The effect of systemic erythropoietin and oral prednisolone on recent-onset non-arteritic anterior ischemic optic neuropathy: a randomized clinical trial. Graefes Arch Clin Exp Ophthalmol 258, 2291–2297 (2020). https://doi.org/10.1007/s00417-020-04781-x

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  • DOI: https://doi.org/10.1007/s00417-020-04781-x

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