Intravenous immunoglobulin in recurrent-relapsing inflammatory optic neuropathy

Hadas Stiebel-Kalish, Naama Hammel, Judith Van Everdingen, Ruth Huna-Baron, Andrew G. Lee

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Objective: Recurrent-relapsing inflammatory optic neuropathy, including chronic relapsing inflammatory and auto-immune optic neuropathies, is rare, but can cause severe visual loss. Long-term steroids may preserve vision, yet side effects are frequent. We describe our experience with intravenous immunoglobulins (IVIg). Design: A semi-prospective case series from 4 medical centres. Participants: Patients with steroid responsive recurrent-relapsing optic neuropathy. Methods: Semiprospective case series of IVIg treatment in steroid-responsive recurrent-relapsing optic neuropathy at 4 medical centres. Outcome measures included visual outcome; time to, and duration of, remission; duration of corticosteroid use; and adverse events. Results: Vision stabilized in all 6 patients treated with IVIg without steroids for extended periods of time. None improved and none worsened. One adverse event occurred during an IVIg infusion after 3 uneventful years of IVIg maintenance. Average steroid use prior to IVIg was 12 months. After IVIg treatment, 5/6 patients no longer required corticosteroids. Two patients experienced late relapses on IVIg, one of whom was treated with cyclosporine, the other with steroids. Conclusions: IVIg can be considered an effective steroid-sparing agent in selected cases with steroid-dependent recurrent-relapsing autoimmune optic neuropathy.

Original languageEnglish (US)
Pages (from-to)71-75
Number of pages5
JournalCanadian Journal of Ophthalmology
Volume45
Issue number1
DOIs
StatePublished - Jan 1 2010

Keywords

  • Immune system disease
  • Immunology
  • Neuro-ophthalmology
  • Optic neuritis

ASJC Scopus subject areas

  • Ophthalmology

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