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.