IV Steroid Treatment

Intravenous (IV) steroid treatment delivers high doses of corticosteroids directly into the bloodstream. It's used for acute inflammatory conditions affecting the optic nerve and visual system.

Common Uses

• Acute optic neuritis
• Giant cell arteritis (initially)
• NMO attacks
• MOGAD attacks
• Severe thyroid eye disease
• Other inflammatory optic neuropathies

What to Expect

Before Treatment

• Blood tests (glucose, electrolytes)
• Blood pressure check
• Review of current medications
• May need IV line placed

During Treatment

• IV infusion over 1-2 hours
• Usually methylprednisolone 1 gram daily
• Typically 3-5 consecutive days
• Can be done outpatient in infusion center

Side Effects During Infusion

• Metallic taste
• Flushing
• Mild restlessness
• Sleep disturbance
• Elevated blood sugar

After Treatment

Short-Term Effects

• Mood changes (up or down)
• Insomnia
• Increased appetite
• Elevated blood pressure
• High blood sugar

Oral Steroid Taper

• Often prescribed after IV course
• Gradual dose reduction over weeks
• Prevents rebound inflammation

For Optic Neuritis

Based on the ONTT (Optic Neuritis Treatment Trial):

• Speeds recovery but doesn't change final vision
• May reduce risk of MS in short term
• Standard approach for moderate-severe cases

For Giant Cell Arteritis

• Often life-saving and vision-saving
• Started immediately when suspected
• Followed by oral steroids for months
• Don't wait for biopsy results