To investigate the effect of combined intravenous erythropoietin and corticosteroid as well as systemic steroid alone for the treatment of non-arteritic anterior ischemic optic neuropathy (NAION).

: In this prospective interventional comparative case series, 113 consecutive patients diagnosed with recent onset (less than 14 days) NAION were included. Patients were categorized into 3 groups. Forty patients received systemic corticosteroid combined with recombinant human erythropoietin (rhEPO) (group 1), 43 patients received systemic corticosteroid alone (group 2), and 30 patients were enrolled as control group (group 3). Functional and structural outcomes were analyzed 3 and 6 months after treatment. Best corrected visual acuity (BCVA) was the main outcome, and mean deviation (MD) and peripaillary retinal nerve fiber layer thickness (PRNFLT) were secondary outcome measures.

The mean BCVA at the time of presentation was 0.98 (± 0.65), 0.96 (± 0.67), and 1.02 (± 0.63) log MAR in group 1, 2, and 3, respectively (P=0.95). At month 3, the corresponding values were 0.73 (± 0.45), 0.76 (± 0.49), 0.8 (± 0.45) log MAR (P= 0.80), and at six-months follow up, were 0.76 (± 0.45), 0.71 (± 0.4), 0.71 (± 0.46) log MAR, respectively (P=0.87). There was no statistically significant difference in BCVA between month 3 and 6, which implies stabilization of the visual acuity by month 3. Considering the visual field, within 6 months of follow up after disease onset; MD index improved in all groups with no statistically significant differences between them (P=0.82).

we found no beneficial effect of either systemic steroid alone or combined with erythropoietin in visual outcome of NAION patients.