Journal List > J Korean Ophthalmol Soc > v.49(1) > 1008069

Kim and Ahn: Side Effects of Intravenous Methylprednisolone Pulse Therapy in Eye Diseases

Abstract

Purpose

To determine the side effects of short-term high-dose methylprednisolone therapy (pulse methylprednisolone therapy), which was used to treat patients with optic neuritis, traumatic optic neuropathy, orbital pseudotumor, and orbital myositis.

Methods

All 27 patients treated with pulse methylprednisolone therapy from June 2005 to June 2006 were included in this study. Each patient was injected with 1 g per day of methylprednisolone intravenously, administered in 250 mg doses every 6 hours, for 3 days. We measured body mass index (BMI), fasting glucose, HbA1c, blood pressure, and intraocular pressure. In addition, we performed slit lamp examination and chest X-ray.

Results

The average age of the 27 patients was 35.8 years, including 16 males and 11 females. Thirteen patients had optic neuritis, 10 patients had traumatic optic neuropathy, 3 patients had orbital pseudotumors, and 1 patient had orbital myositis. Before treatment, the average of body mass index (BMI) was 23.09 (kg/m2), but at 3 months after treatment it was 23.73 (kg/m2). All patients had fasting glucose levels higher than the normal range during the treatment. However, all fasting glucose levels returned to within the normal range at 3 months after treatment, except in 1 patient. In addition, a major complaint among patients was an increase in body weight.

Conclusions

We performed a close observation of controlled diet and exercise on patients who were treated with pulse methylprednisolone therapy because we knew it would have a hyperglycemic effect. An increase in body weight is the most common complaint of steroid therapy. Even after treatment is completed, it is important to monitor glucose level and weight.

References

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Figure 1.
The changes of fasting blood glucose.
jkos-49-14f1.tif
Table 1.
General characteristics of patients
Age (years) 35.8 +/- 17.9
Gender
 Male 16
 Female 11
Disease
 Optic neuritis 13
 Traumatic optic neuropathy 10
 Orbital pseudotumor 3
 Orbital myositis 1
Table 2.
Differences between before and after the treatment by paired t-test
Before treatment 3 months after treatment P value
Body Mass Index (kg/m2) 23.09 +/- 0.09 23.73 +/- 0.14 0.019
HgA1c (%) 6.2 +/- 1.4 6.8 +/- 1.1 0.549
Blood pressure (mmHg)
 Systolic 117.8 +/- 10.4 125.8 +/- 34.2 0.446
 Diastolic 76.7 +/- 10.75 77.9 +/- 8.61 0.756
Intraocular pressure (mmHg) 15.4 +/- 3.6 16.2 +/- 2.4 0.778

HgA1c, blood pressure, and intraocular pressure were not significantly increased.

Body mass index was significantly increased after the treatment.

Table 3.
Discomforts after the treatment
Symptom Person
Gain of weight 24
Erythema or edema of face 19
Skin lesion (inclusion acne) 14
Increase of appetite 9
Unstable state of mood 7
Edema of whole body 4
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