Definition
Optic neuritis is an inflammatory disease involving the optic nerve. In the long run, this disease can cause severe and permanent damage to the eye, such as partial loss of vision or blindness.
In most cases, inflammation affects only one eye, but the possibility that both eyes will be affected by the disease is not entirely excluded.
Causes
Optic neuritis is caused by damage to the optic nerve and the myelin sheath that covers it. Damage to this sheath, in fact, prevents the nerve from conducting electrical impulses adequately, thus altering the signals that reach the brain from the eye. All this translates into a reduction in vision.
Damage to the myelin sheath can be caused by autoimmune diseases (such as multiple sclerosis, Devic's syndrome, systemic lupus erythematosus, Behçet's disease, sarcoidosis, etc.), by infections (such as syphilis, meningitis, Lyme disease, chicken pox, measles, mumps, infections caused by Herpes zoster, etc.), or from trauma or other pathologies and disorders, such as, for example, tumors, ischemias, diabetes, nutritional deficiencies, etc.
However, the most common cause of optic neuritis is multiple sclerosis.
Symptoms
The characteristic symptoms of optic neuritis are eye pain, decreased visual acuity and altered color perception.
Other symptoms that can occur in patients with optic neuritis are anisocoria, narrowing of the visual field, night blindness, floaters, halos around light, photophobia, scotoma and intraocular bleeding.
Finally, optic neuritis can lead to partial or total loss of vision.
The information on Optic Neuritis - Drugs for the Treatment of Optic Neuritis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Optic Neuritis - Drugs for the Treatment of Optic Neuritis.
Medicines
In some cases, optic neuritis is a transient disorder that tends to resolve itself within a few weeks or months, without resorting to any type of drug therapy.
However, when optic neuritis is caused by other pathologies or disorders, it is necessary to intervene on the primary causes that triggered the disease itself. Therefore, if at the base of the optic neuritis there is an "infection (bacterial or viral) it is necessary to institute an" adequate therapy aimed at contrasting the infectious agent, through the use of appropriate antibiotic or antiviral drugs, depending on the case. .
If, on the other hand, at the base of the optic neuritis there is multiple sclerosis - as occurs in the majority of cases - to accelerate the healing times, a pharmacological treatment can be instituted which involves the administration of intravenous corticosteroids.
Furthermore - when the triggering cause of optic neuritis is an autoimmune disease - immunomodulatory or immunosuppressive drugs can be used to decrease the frequency of attacks.
The following are the classes of drugs most used in the therapy against optic neuritis and some examples of pharmacological specialties; it is up to the doctor to choose the active ingredient and dosage most suitable for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment.
Corticosteroids
When the cause of optic neuritis lies in multiple sclerosis, doctors usually prescribe intravenous corticosteroid treatment to speed recovery. Thereafter, therapy can be continued by taking oral corticosteroids.
Due to the side effects caused by corticosteroids, their use must be under close medical supervision.
Among the most used active ingredients, we remember:
- Methylprednisolone (Urbason ®, Medrol ®, Solu-Medrol ®): methylprednisolone is available in different pharmaceutical formulations suitable for different routes of administration.
When administered intravenously, the usual dose of methylprednisolone (in the form of methylprednisolone sodium succinate) is 30 mg / kg of body weight, to be administered over a period of at least 30 minutes. It should be remembered that treatment with such high doses of methylprednisolone should only be carried out for short periods (maximum 48-72 hours).
When administered orally, however, the dose of methylprednisolone used can vary from 4 mg up to 48 mg per day.
However, the initial amount of drug to be administered and the optimal maintenance dose for each patient must be determined by the physician. - Prednisone (Deltacortene ®): Prednisone is available for oral administration and can be used to continue steroid therapy following intravenous methylprednisolone administration. The drug dose usually administered is 10-15 mg per day. Also in this case, the exact dosage of the drug will have to be established by the doctor on an individual basis for each patient.
Other drugs for the (indirect) treatment of optic neuritis
- Natalizumab (Tysabri ®): natalizumab is a monoclonal antibody with a specific indication for the treatment of multiple sclerosis. It is available for intravenous administration and should only be administered by personnel specialized in the treatment of this condition. The dose usually used is 300 mg of the drug, to be administered by intravenous infusion every four weeks.
- Cyclophosphamide (Endoxan Baxter ®): cyclophosphamide is an anticancer drug that can be used in the treatment of various autoimmune diseases thanks to its immunosuppressive action. It is a drug available for both oral and intravenous administration. The amount of active ingredient to be used must be determined by the physician on an individual basis.
- Methotrexate (Methotrexate Teva ®, Reumaflex ®): methotrexate is also an anticancer drug which, thanks to its immunosuppressive action, can be used to treat various types of autoimmune diseases. It is available for oral and parenteral administration. The route of administration and the amount of drug to be used must be established by the doctor according to the autoimmune disease to be treated.
These drugs, therefore, are not used directly for the treatment of optic neuritis itself, but for the treatment of the autoimmune diseases that underlie this inflammation.
