Erythropoietin: a novel treatment for traumatic optic neuropathy—a pilot study

Abstract

To determine the visual outcome and safety of intravenous erythropoietin in patients with indirect traumatic optic neuropathy (TON). In a university-based hospital, from December 2008 to March 2010, seven cases with indirect TON (EPO group) received three intravenous (IV) injections of 10,000 IU of recombinant human erythropoietin in three successive days. They were compared to eight patients with indirect TON who had received no specific treatment from December 2006 to November 2008 (observation group). The primary end point was best-corrected visual acuity (BCVA) in both groups at last follow-up and secondary measure was systemic adverse effects of medication in the EPO group. Mean ages of patients in the observation and EPO groups were 23.3 (SD = 10.8) and 19.7 (SD = 12.1) years, respectively. Mean follow-up in the observation and EPO groups were 5.8 (SD = 3.8) and 7.0 (SD = 5.8) months, respectively. Mean best-corrected visual acuity (BCVA) significantly (p = 0.028) improved from 1.82 logMAR (SD = 1.27) at initial visit to 0.94 logMAR (SD = 0.82) at last follow-up in the EPO group, whereas the observation group showed an insignificant (p = 0.285) improvement from 2.55 log MAR (SD = 0.62) to 2.32 logMAR (SD = 0.83). Mean final BCVA was significantly higher in the EPO group than in the observation group (p = 0.012). Two cases developed mild transient systemic hypotension during EPO injection. Intravenous erythropoietin may be a new effective and safe treatment for patients with indirect TON.