Oral Steroids for Vision Issues

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Oral Steroids for Vision Issues

Postby LoveActually » Fri Jan 21, 2011 2:05 pm

I have learned that it's not a good idea to use oral steroids for vision issues and that IV is preferred. I cannot remember the reason for this. LOL! Can some please refresh my memory?

Thanks!
October 29, 2009 - Dx with RRMS
June 22, 2010 - Dx's changed to Devic's (NMO)
January 4, 2011 - Dx w/Syringomyelia T4-T9, Migraines, and Possible MS (again - long story)
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Postby Lyon » Fri Jan 21, 2011 4:07 pm

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Last edited by Lyon on Sun Nov 20, 2011 3:38 pm, edited 1 time in total.
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Postby LoveActually » Fri Jan 21, 2011 4:54 pm

Thanks Lyon!
October 29, 2009 - Dx with RRMS
June 22, 2010 - Dx's changed to Devic's (NMO)
January 4, 2011 - Dx w/Syringomyelia T4-T9, Migraines, and Possible MS (again - long story)
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Postby patientx » Fri Jan 21, 2011 7:50 pm

Of course you'll want to consult with your doc, but I've read that oral steroids are usually used as a taper, coming off the IV steroids. (Disclaimer, I've never had steroids.)
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Postby EyeDoc » Sat Jan 22, 2011 8:54 am

IV steroids followed by an oral steroid taper is the preferred treatment. Oral steroids don't have the treatment effect desired when used alone, but they will work well after the IV treatment. I would love to explain this more succinctly, but MS is fogging my brain this morning :)
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Postby elliberato » Thu Jan 27, 2011 11:34 am

oral steroids are poison. My last episode only seemed to get worse off the damn things. Its like your damned if you do and damned if you dont. Xanax actually works better for me. My doc never tapered me off iv. Consider doing 1/2 dose IV seems the benefit can be about as good as the full dose without all the anxiety. Boy MS doesnt discriminate does it, you sure are a sight for soar eyes :D
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Postby LoveActually » Thu Jan 27, 2011 1:15 pm

Thank you all. I've managed to avoid steroids thus far but there was one time when my neuros NP prescribed me only oral steroids for vision issues. He was not happy about this and explained to me why but I couldn't remember.
October 29, 2009 - Dx with RRMS
June 22, 2010 - Dx's changed to Devic's (NMO)
January 4, 2011 - Dx w/Syringomyelia T4-T9, Migraines, and Possible MS (again - long story)
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Location: Southern California

Oral steriods cause Brain Atrophy

Postby jackD » Thu Jan 27, 2011 9:37 pm

Oral steriods cause Brain Atrophy.

jackD

Mult Scler 2002 Oct;8(5):415-9

Cerebral volume changes in multiple sclerosis patients treated with
high-dose intravenous methylprednisolone.

Hoogervorst EL, Polman CH, Barkhof F

Department of Neurology, VU Medical Center, Amsterdam, The
Netherlands.

OBJECTIVE: Multiple sderosis (MS) patients develop varying degrees of
cerebral atrophy, which may already begin at disease onset The
purpose of this study is to examine the effect of steroid treatment
on cerebral volume in MS patients.

METHODS: Thirty-five MS patients
participating in a clinical trial of oral interferon beta, which
induded monthly MRI, were included in this study. They suffered from
an acute relapse and were treated with intravenous methylprednisolone
(IV-MP); 13 of the patients were treated with oral prednisolone
tapering after IV-MP. The last MRI scan before and the first (and
second for oral tapering patients) scan after IV-MP treatment were
used for measuring parenchymal fraction (PF) and ventricular fraction
(VF). Changes in PF and VF were analysed using Student's t test.

RESULTS: For the total population no significant changes in PF or VF
were found.

However, the subgroup of patients receiving oral tapering
after IV-MP showed changes, compatible with atrophy in both PF and
VF, that were significant immediately after IV-MP treatment and still
persisted (though not statistically significant anymore) after a mean
interval of 30 days. The magnitude of these changes was about the
same as the annual change in cerebral volume as reported in natural
history studies.

CONCLUSION: Our data indicate that short courses of
intravenous steroids (restricted to three or five days) have no major
impact, [b]whereas prolonged treatment with oral tapering does
significantly affect brain volume.
These findings are important for
longitudinal studies and clinical trials in which brain volume is
used as an outcome measure.[/b]

PMID: 12356209, UI: 22243022
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