Randomized control trial of evaluation of Clemastine effects on visual evoked potential, nerve fiber layer and ganglion cell layer complex in patients with optic neuritis

Moghaddasi, Mehdi; Nabovvati, Mona; Koushki, Amin; Soltan-Sanjari, Mostafa; Sardarinia, Mahsa; Mohebi, Nafiseh; Rabani, SeyedHossein

doi:10.1016/j.clineuro.2020.105741

Cited by 11 publications

(16 citation statements)

References 20 publications

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“…We performed a full-text evaluation of these articles, and two articles were further excluded: one because of unclear duration from symptom onset [ 16 ] and the other because it targeted patients with vitamin D deficiency, which was not the focus of our study [ 17 ]. Ultimately, nine studies were eligible for inclusion in our meta-analysis [ 13 , 14 , 15 , 18 , 19 , 20 , 21 , 22 , 23 ]. The study selection process is illustrated in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Among the included studies, two were prospective cohort studies, and the others were RCTs. Regarding study population, one study specifically investigated acute optic neuritis in patients with MS [ 21 ], and two studies recruited patients with acute optic neuritis as a clinically isolated syndrome [ 19 , 22 ]. Although we considered all studies with a duration of symptom onset within 30 days, only three studies included patients who had symptoms for more than 14 days prior to seeking medical care or being recruited.…”

Section: Resultsmentioning

confidence: 99%

“…In terms of OCT outcome, three studies evaluated follow-up OCT at 6 months [ 14 , 15 , 20 ], two studies at 4 months [ 13 , 19 ], and two studies at 3 months [ 18 , 21 ]. All seven studies collected RNFL thickness as their outcome; two of these studies provided data on RNFL thickness in the unaffected fellow eye at baseline [ 15 , 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…We performed meta-analyses to compare the change in RNFL thickness with that of the baseline for the affected eye as well as the unaffected fellow eye. In addition to RNFL thickness, Moghaddasi et al included ganglion cell layer thickness as one of their outcomes [ 21 ]. Yadegari et al selected GCIPL thickness as their primary outcome of interest [ 14 ].…”

Section: Resultsmentioning

confidence: 99%

“…The methodological quality of the included RCTs is summarized in Figure 2 . Five trials were described as RCTs, each reporting an acceptable method of randomization [ 13 , 14 , 15 , 18 , 21 ]. All RCTs described the generation of random sequences with computer software or number tables and emphasized allocation concealment during randomization, except for the studies of Moghaddasi et al [ 21 ] and Yadegari et al [ 14 ].…”

Section: Resultsmentioning

confidence: 99%

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Neuroprotective Effects of Novel Treatments on Acute Optic Neuritis—A Meta-Analysis

et al. 2022

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Optic neuritis, inflammation of the optic nerve, can cause visual impairment through retinal nerve fiber layer (RNFL) degeneration. Optical coherence tomography could serve as a sensitive noninvasive tool for measuring RNFL thickness and evaluating the neuroprotective effects of treatment. We conducted a meta-analysis to compare RNFL loss between novel add-on treatments and corticosteroid therapy at least 3 months after acute optic neuritis. The outcome measures were mean differences (MDs) in (1) RNFL thickness compared with the baseline in the affected and unaffected eye and (2) LogMAR visual acuity (VA). Seven studies involving five novel agents (memantine, erythropoietin, interferon-beta, phenytoin, and clemastine) were analyzed. When compared with the baseline RNFL thickness of the affected eye, the neuroprotective effects of novel add-on treatments could not be demonstrated. The difference in visual outcomes was also not significant between the two treatment groups. One study revealed that phenytoin has the potential to alleviate RNFL loss when the baseline thickness of the unaffected eye is considered. Larger randomized controlled trials with suitable outcome measures are warranted to evaluate the neuroprotective effects of novel treatments. Further studies should also tailor therapies to specific patient populations and investigate a more targeted treatment for acute optic neuritis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Neuroprotective Effects of Novel Treatments on Acute Optic Neuritis—A Meta-Analysis

et al. 2022

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Retinal imaging with optical coherence tomography in multiple sclerosis: novel aspects

Olbert

Struhal

2022

Wien Med Wochenschr

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SummaryOptical coherence tomography (OCT) is of increasing interest in the clinical assessment of multiple sclerosis (MS) patients beyond the scope of clinical studies. In this narrative review, we discuss novel changes of OCT parameters during acute optic neuritis and the disease course of MS patients. OCT images document the changes of retinal layers during an episode of acute optic neuritis and can therefore provide valuable insights into the pathophysiology. Moreover, MS patients show progredient thinning of retinal layers throughout the disease. The thinning is accelerated through relapses as well as disease progression without relapse. The OCT parameters are also associated with clinical outcome parameters, including disability, cognitive function, and brain atrophy. The impact of disease-modifying therapies on OCT parameters is the subject of ongoing research and depends on the agent used. Additional data are still necessary before OCT parameters can be implemented in the clinical standard of care of MS patients.

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Biomarker Defined Acute Optic Neuritis: A Review and Perspective

Gostimir,

Sergott

2023

Curr Treat Options Neurol

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Randomized control trial of evaluation of Clemastine effects on visual evoked potential, nerve fiber layer and ganglion cell layer complex in patients with optic neuritis

Cited by 11 publications

References 20 publications

Neuroprotective Effects of Novel Treatments on Acute Optic Neuritis—A Meta-Analysis

Neuroprotective Effects of Novel Treatments on Acute Optic Neuritis—A Meta-Analysis

Retinal imaging with optical coherence tomography in multiple sclerosis: novel aspects

Biomarker Defined Acute Optic Neuritis: A Review and Perspective

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