| Title | Timing of Corticosteroid Therapy is Critical to Prevent Retinal Ganglion Cell Loss in Experimental Optic Neuritis. | | Author(s) | Dutt M, Tabuena P, Ventura E, Rostami A, Shindler KS | | Institution | Ophthalmology, University of Pennsylvania, Philadelphia, United States. | | Source | Invest Ophthalmol Vis Sci 2009 Nov 5. | | Abstract | Purpose. Acute vision loss from optic neuritis typically resolves; however, recovery is often not complete, with permanent vision loss from retinal ganglion cell (RGC) death occurring in 40-60% of patients. Current therapy (high-dose corticosteroids) speeds recovery, but does not change final visual outcomes. Here we examine whether corticosteroids administered early in the disease course can prevent RGC loss in experimental optic neuritis. Methods. RGCs were retrogradely-labeled with fluorogold in SJL/J mice. Experimental autoimmune encephalomyelitis (EAE) was induced by immunization with proteolipid protein peptide. Optic neuritis begins 9 days post-immunization. Mice were treated daily with dexamethasone, methylprednisolone, or PBS from days 0-14 or days 10-14, then sacrificed on day 14, 18 or 22.
Results. Corticosteroid treatment initiated prior to optic neuritis onset (days 0-14) suppressed EAE and reduced optic neuritis incidence through day 14. In the few eyes that developed optic neuritis, inflammation was mild and RGC loss was attenuated. After stopping treatment on day 14, mice rapidly developed EAE and optic neuritis by day 18, but RGC loss was still reduced. By day 22, RGC loss increased to levels similar to untreated optic neuritis eyes. Corticosteroid treatment after optic neuritis onset (days 10-14) slowed EAE progression and showed a trend toward suppression of optic neuritis and RGC loss on day 14 that was lost by day 18.
Conclusions. Corticosteroids can suppress optic neuritis and prevent RGC loss if treatment is initiated prior to optic nerve inflammation onset. Treatment is less effective after inflammation begins. Results suggest that chronic immunomodulation may potentially prevent recurrent optic neuritis and RGC damage. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19892867 |
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