Re: MS, ON, retrobulbar steroids

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Posted by CCF Neuro MD on April 24, 1997 at 10:05:15:

In Reply to: MS, ON, retrobulbar steroids posted by MM on April 14, 1997 at 13:31:30:

: My stepdaughter has multiple sclerosis with optic neuritis in both eyes as the most significant manifestation. In the past she has received intravenous methylprednisolone with or without oral prednisone. Her neuro-ophthomologist offered her an alternative retrobulbar block with steroids last time. Do you have any information or comment on this treatment? Thank you.

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Optic neuritis is a common presentation and symptom of Multiple Sclereosis. The standard therapy for this type of flare up of MS is intravenous methylprednisolone. This has been proven to quicken the recovery of optic neuritis better than giving just oral steriods. There has not been any such systematic study of retrobulbar injection of steriod. It is not done routinely, however we have seen it been done in the context of patients who have had optic neuritis that have not responded to intravenous steriod. There is no studies to show that this can be helpful just antedotal evidence. Response to this treatment would also depend on how long the current attack of optic neuritis has lasted. A persistent problem for months is less likely to respond as opposed to a something that has just lasted a week or so. This is a complicated issue and there is no straight forward anwsaer at this point. More studies looking at this procedure have to be done to find out when the procedure is most helpful.
I would encourage you to talk this over with your Neuroopthalmologist and get their input as far as the potential benefit and risks involved with the procedure before you decide to persue with this course of treatment.

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