TY - JOUR
T1 - Intravenous immunoglobulin in recurrent-relapsing inflammatory optic neuropathy
AU - Stiebel-Kalish, Hadas
AU - Hammel, Naama
AU - Van Everdingen, Judith
AU - Huna-Baron, Ruth
AU - Lee, Andrew G.
PY - 2010/1/1
Y1 - 2010/1/1
N2 - 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.
AB - 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.
KW - Immune system disease
KW - Immunology
KW - Neuro-ophthalmology
KW - Optic neuritis
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U2 - 10.3129/i09-238
DO - 10.3129/i09-238
M3 - Article
C2 - 20130715
AN - SCOPUS:76149129763
SN - 0008-4182
VL - 45
SP - 71
EP - 75
JO - Canadian Journal of Ophthalmology
JF - Canadian Journal of Ophthalmology
IS - 1
ER -