IVMP should be limited to speeding up symptom relief in severe IOI patients

Intravenous methylprednisolone (IVMP) should only be used to increase the rate of symptom relief and recovery from optic nerve dysfunction in patients with severe idiopathic orbital inflammation (IOI), according to a study published in the British Journal of Ophthalmology.

Dr Ward R. Bijlsma et al., University Medical Center Utrecht, Department of Ophthalmology, The Netherlands, investigated 15 IOI patients treated between 2000 and 2007. A combination of IVMP pulse therapy and oral prednisone (OP) was used to treat 12 IOI patients. They were known as the IVMP+OP group. A further 15 patients only received OP and they were referred to as the OP-only group. The main outcome measures included duration of prednisone treatment, symptom-free outcome and complications.

The results demonstrated that 87% of patients were symptom-free in the OP-only group, compared to 73% in the IVMP+OP group. There were no complications from prednisone therapy.

The IVMP+OP combination was not significantly better at lowering treatment duration, lowering cumulative dose or decreasing persistent symptoms. The study suggests the use of IVMP to treat IOI is better suited to speeding up relief from symptoms and aiding recovery from optic nerve dysfunction.