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Untoward effects of high-dose methylprednisolone therapy on blood-retinal barrier closure, retinal hole repair, and long-term scarring
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Paper Abstract

Thirty-seven New Zealand Red rabbits were either dosed with methyiprednisolone sodium succinate (MP, n18) about 20 nun before laser irradiafion, or they were left untreated (n=19). Dosing with MP was tapered at 30, 30, 20, 20, and 10 mg/kg/day for five consecutive days. Retinas were irradiated with a multi-lime argon laser to produce retinal injuries (grid of 16 lesions/eye) near hemorrhaging levels (285 mW/lOmsec, 290 ?m retinal spot size). A variety of funduscopic and histologic assessments were made for hemorrhagic and non-hemorrhagic lesions from 10 miii to 6 mo after injury. Fluorescein angiography showed that non-hemorrhagic control lesions stopped leaking at 3d post injury, but MPtreated lesions leaked for 2-4 days longer. After MP treatment, funduscopic lesion areas were similar to controls during the first 24 h then became smaller by 1 mo. After 1 mo, MP-treated lesions increased in area while controls became reduced. Histologic analysis showed no effect on reduction of neutrophils (PMN) in MP-treated lesions over controls at 3 hr. At 24 hi, retinal PMN values in hemorrhagic lesions ofthe MP group were elevated (p<0.05) while monocyte/macrophage counts were reduced (p<0.05) compared to control. At 4d, MP impeded replacement oflost retinal tissue, and contributed to retinal hole development at 1 mo followed by extensive enhancement of chorio-retinal scarring at 6 mo. In severe laser-induced retinal trauma, the immunosuppressive effects of high dose MP therapy contributed to a variety of untoward wound healing outcomes, thereby suggesting caution in its use to treat similar injuries in humans.

Paper Details

Date Published: 17 May 2001
PDF: 9 pages
Proc. SPIE 4246, Laser and Noncoherent Light Ocular Effects: Epidemiology, Prevention, and Treatment, (17 May 2001); doi: 10.1117/12.426715
Show Author Affiliations
Steven T. Schuschereba, Walter Reed Army Institute of Research (United States)
Jeremiah Brown, Walter Reed Army Institute of Research (United States)
Bruce E. Stuck, Walter Reed Army Institute of Research (United States)
John Marshall, St. Thomas' Hospital (United States)

Published in SPIE Proceedings Vol. 4246:
Laser and Noncoherent Light Ocular Effects: Epidemiology, Prevention, and Treatment
Bruce E. Stuck; Michael Belkin, Editor(s)

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