New features to increase the efficiency of pathogenetic treatment of optic neuritis
Egorov V.V.^1,2, Povalyaeva D.A.¹, Smolyakova G.P.^1,2, Danilova L.P.^1,2, Emanova L.P.<sup>1

1</sup> The Khabarovsk branch of the State Institution Eye Microsurgery Complex named after S.N. Fyodorov 
² Postgraduate Institute for Public Health Workers, Khabarovsk 

Objective. To evaluate the clinical effectiveness of the irrigation-infusion method of local glucocorticosteroid (GCS) therapy in patients with optic neuritis (ON).
Material and methods. The study involved 40 patients (49 eyes) with ON aged from 17 to 36 years (avg 26.4±5.7 years). Depending on the method of GCS infusion – dexamethasone, patients were divided into two groups: main (23 pers. – 28 eyes) and control (17 pers. – 21 eyes). Patients of the main group received dexamethasone infusion to the optic nerve through the implanted in the retrobulbar space irrigation system in the first half of the day at a dose of 2 mg. During first four days – 4 infusions (daily dose of 8 mg); on days 5–7 – 3 infusions (6 mg); on days 8–9 – 2 infusions (4 mg); on tenth day – 1 infusion (2 mg). The total dose of dexamethasone was 60 mg. Control group received dexamethason intravenously at a dose of 8 mg during first 4 days, then 3 days – 6 mg, 2 days – 4mg and the last 10th day – 2 mg. Additionally during these10 days patients received daily retrobulbar dexamethasone injections at a dose of 2 mg. The total dose of dexamethasone was 80 mg.
Results and discussion.  All studied parameters improved in both groups of patients with OТ after GCS treatment. However, a more significant positive changes and shortening the terms of their occurrence were obtained in the main group during the topical corticosteroids therapy by irrigation-infusion method in comparison with the control group who received traditional GCS treatment regimen.
Conclusions. Clinical and functional benefits of infusion-irrigation method of corticosteroids retrobulbar infusion  compared to the traditional scheme of infusion is 1.3 times increase of visual acuity  and 2.7 times reduction of incidence of postneuritic optic nerve atrophy during 12 months follow-up.
Compared with the traditional scheme of GCS therapy irrigation-infusion method reduces terms of recovery of lost visual functions by 3 times, and decreases the total corticosteroid dose in 1.2 times.

Key words: optic neuritis, corticosteroid therapy, address delivery, dexamethasone.

For citation: Egorov V.V., Povalyaeva D.A., Smolyakova G.P., Danilova L.P., Emanova L.P. New features to increase the efficiency of pathogenetic treatment of optic neuritis // RMJ. Clinical ophthalmology. 2016. № 3. P. 140–144.