PURPOSE To examine the role of oral steroid therapy in the treatment of nondiabetic cases of acute nonarteritic anterior ischemic optic neuropathy (NAAION). DESIGN Randomized double-blind clinical trial. PARTICIPANTS Thirty-eight patients with acute nondiabetic NAAION divided into 2 arms of 19 patients each. One arm constituted the cases and the other constituted the controls. METHODS Cases received oral steroid therapy and were designated the steroid group, whereas controls received placebo and were designated the nonsteroid group. Best-corrected visual acuity (BCVA), visual evoked response (VER), and OCT were performed at baseline, 1 month, 3 months, and 6 months after recruitment into the trial. MAIN OUTCOME MEASURES Best-corrected visual acuity, VER, and retinal nerve fiber layer changes on OCT. RESULTS Both groups showed significant improvement in BCVA, VER latency, and resolution of disc edema on OCT parameters over 6 months. Final outcome showed no statistically significant difference with regard to visual acuity, although VER was better in the steroid group (P = 0.011). Best-corrected visual acuity, VER amplitude, and VER latency (P = 0.02, P = 0.02, and P = 0.04, respectively) showed a greater percentage improvement in the steroid group, which also saw a faster resolution of disc edema on OCT (1-month follow-up). CONCLUSIONS Oral steroids in acute NAAION did not improve the visual acuity significantly at 6 months. However, they improved resolution of disc edema significantly and enabled a greater improvement in VER parameters. This subtle benefit of oral steroids in NAAION is clinically unimportant and does not provide support for its use.

中文翻译：

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类固醇与非类固醇在非动脉性前部缺血性视神经病变中的比较：一项随机对照试验。

目的探讨口服类固醇疗法在治疗非糖尿病性急性非动脉性前部缺血性视神经病变（NAAION）的病例中的作用。设计随机双盲临床试验。参与者38例急性非糖尿病性NAAION患者分为两组，每组19例。一只手臂构成案件，另一只手臂构成控件。方法接受口服类固醇治疗的患者被指定为类固醇组，而对照组接受安慰剂的患者被指定为非类固醇组。入选试验后的基线，1个月，3个月和6个月时进行最佳矫正视力（BCVA），视觉诱发反应（VER）和OCT。主要观察指标OCT上最佳矫正的视敏度，VER和视网膜神经纤维层变化。结果两组均显示，在6个月内，BCVA，VER潜伏期和OCT参数的椎间盘水肿消退明显改善。尽管VER在类固醇组中较好（P = 0.011），但最终结局在视敏度上没有统计学上的显着差异。最佳矫正视力，VER幅度和VER潜伏期（分别为P = 0.02，P = 0.02和P = 0.04）显示类固醇组的百分比改善更大，这也显示了OCT上椎间盘水肿的缓解速度更快（ 1个月的随访）。结论急性NAAION中的口服类固醇在6个月时并未显着改善视力。但是，它们显着提高了椎间盘水肿的分辨率，并大大改善了VER参数。