The Efficacy of Glucocorticoids in the Treatment of Nonarteritic Anterior Ischemic Optic Neuropathy: A Systematic Review and Meta-Analysis

Abstract

Background. To evaluate the clinical effects and safety of glucocorticoids for patients with nonarteritic anterior ischemic optic neuropathy (NAION). Methods. The databases MEDLINE, Embase, PubMed, Cochrane Database, and Web of Science were used to search for the relevant studies, and full-text articles that reported on the evaluation of glucocorticoids vs. no-treatment or placebo for patients with NAION. Review Manager 5.4 was used to estimate the pooled effects of the results among selected studies. Forest plots, funnel plots, and Begg’s rank correlation were also performed on the included articles. Results. A total of 983 patients were contained in the 9 studies that satisfied the eligibility criteria. The meta-analysis showed that, compared with the control group, the glucocorticoid group had significantly improved the VA (MD: -0.25, 95% CI [-0.45, -0.05], $P=0.02$ ), VF (MD: -0.50, 95% CI [-0.94, -0.07], $P=0.02$ ), and RNFL (MD: -14.10, 95% CI [-26.41, -1.79], $P=0.02$ ) in NAION patients and had a high improvement rate of VA (RR 1.31, 95% CI [1.12, 1.52], $P=0.0005$ ). No significant publication bias was observed in our study. Discussion. Our research preliminarily confirmed the effectiveness of glucocorticoids for NAION treatment, but more high-quality RCTs focusing on the hormone adverse reactions should be performed to verify our conclusions.