Demographic features, diagnosis, previous corticosteroid therapy and side effects, dose and duration of corticosteroid sparing therapy, and outcome of therapy in ten patients with corticosteroid dependent optic neuritis
| Patient no | Age/sex/race | Diagnosis | Eye* | Most consistent corticosteroid dose, total duration of corticosteroid treatement at any dose, and indication for corticosteroid sparing agent. | Drug dose and duration | Adverse effects | Corticosteroid dose (final) | Initial visual acuity | Final visual acuity | Comment |
|---|---|---|---|---|---|---|---|---|---|---|
| F, female; W, white; H, Hispanic; OD, right eye; OS, left eye; OU, both eyes; IV, intravenous; HM, hand motions; CF, counting fingers; LP, light perception; NLP, no light perception. | ||||||||||
| *Uninvolved eyes are not detailed in this table. | ||||||||||
| 1 | 66/F/W | Optic neuritis | OD | 20 mg for 6 years; 25 pound weight gain, mood change, tremor | Mycophenylate mofetil 2000 mg daily for 16 months | Anaemia and increased blood urea nitrogen with 3000 mg daily dose | 3–10 mg | 20/25 | 20/25 | Patient reported improved mood, increased energy and improved vision with mycophenylate. |
| 2 | 52/F/W | Optic neuritis | OU | 15 mg for 18 months; 35 pound weight gain | Cyclophosphamide 125 mg by mouth daily for 13 months | Mild anaemia | 0 mg | OD:HM OS:20/40 | OD:NLP OS:20/30 | Optic nerve biopsy pathology showed non-specific inflammation. |
| 3 | 25/F/W | Optic neuritis | OU | 20 mg for 6 months; 25 pound weight gain, labile mood | Methotrexate 20 mg weekly for 6 months | Headache, fatigue | 17–40 mg | OD:CF OS:CF | OD:20/20 OS:20/20 | Continued flares of optic neuritis despite therapy. |
| Cyclosporine 200 mg daily in combination with methotrexate 20 mg weekly for 1 month | Hypertension, paresthesias | |||||||||
| Mycophenylate mofetil 3000 mg daily for 3 months | Headache | |||||||||
| 4 | 62/F/W | Optic neuritis with hearing loss and cranial neuropathies (VII/VI) | OS | 60 mg for 14 months; 55 pound weight gain, oedema, diabetes, osteoporosis, palpitations, bruising | Azathioprine 200 mg daily for 8 months | Hair loss | Patient discontinued all medications | 20/60 | 20/60 | Patient reported increased energy and stabilisation of weight on azathioprine but was poorly compliant. |
| 5 | 29/F/W | Optic neuritis | OU | 30 mg for 2 years; 25 pound weight gain, mood changes, oedema, arthralgia | Methotrexate 20 mg weekly for 4 months | None | 0–5 mg | OD:20/HM OS: 20/20 | OD: 20/HM OS: 20/20 | Cranial neuropathy (VI) concurrent with optic neuritis. Patient is deceased (cause of death undetermined). |
| Azathioprine 100 mg daily for 6 weeks | Headache, hypertension, nausea | |||||||||
| Mycophenylate mofetil 500 mg daily for 3 weeks | Nausea, headache | |||||||||
| Cyclophosphamide 200 mg daily for 42 months | Nausea, haemorrhagic cystitis | |||||||||
| 6 | 60/F/W | Sarcoidosis | OD | 30–60 mg for 35 years; diabetes, weight gain, non-healing wounds | Methotrexate 7.5 mg weekly for 7 months | None | 20 mg | CF | CF | APD better by 0.9 log units. Patient has severe lung disease. |
| 7 | 56/F/W | Sarcoidosis | OD | 60 mg for at least 4 months; 35 pound weight gain, cushingoid, weakness, labile mood, decreased energy | Azathioprine 150 mg daily for 55 months | Mild hair loss | 0 mg | 20/30 | 20/20 | Patient has restarted corticosteroid therapy per her internist since her last visit for active lung disease. |
| 8 | 55/F/W | Sarcoidosis | OU | 40–60 mg for 2 years; 20 pound weight gain, palpitations, sleep disruption, labile mood | Methotrexate 20 mg weekly for 42 months | None | 10–20 mg | OD:20/20 | OD:CF | |
| Azathioprine 50 mg daily for 1 week | ?Fever, irritation | OS:20/40 | OS:20/40 | |||||||
| Mycophenylate mofetil 2000 mg daily for 5 months | Paresthesias | |||||||||
| Hydroxycholorquine 200 mg daily and methotrexate 20 mg weekly for 2 months | None | |||||||||
| 9 | 53/F/W | Systemic lupus erythematosus | OU | 60 mg for 10 years intermittently; diabetes, cushingoid | Cyclophosphamide 1650 mg IV every six weeks for 12 months | Pneumonitis, nausea | 4 mg | OD:NLP OS:LP | OD:20/30 OS: 20/25 | |
| 10 | 50/F/H | Systemic lupus erythematosus, thyroid related immune orbitopathy | OD | 20 mg for 8 years; 60 pound weight gain, no benefit from corticosteroid | Mycophenylate mofetil 2000 mg daily for 3 months | Hair loss | 0 mg | OD:20/HM OS:20/40 | OD:20/150 OS:20/20 | Patient has a history of repaired retinal detachment OD and radiation therapy to both orbits. |