[Megadose steroid therapy in papillitis with progressive visual loss].

A megadose steroid therapy with 1000 mg methylprednisolone i.v. per day given for several days was tried in two patients with papillitis, in whom a progressive visual loss had been observed for two weeks. In both cases a prompt and extensive recovery occurred. In two additional patients with progressive visual loss caused by papillitis megadose steroid therapy could not be given because of oto-rhinological and dental contraindications. Based on the assumption that the rapid recovery observed after the megadose steroid therapy of neuritis may have resulted essentially from an antiedematous effect, a purely antiedematous treatment with infusions of mannitol was given. In both patients visual acuity returned as promptly as in the patients treated with megadose steroids. These four observations together with reports of the literature indicate that the megadose steroid therapy, and perhaps a purely antiedematous therapy, are of potential benefit in selected cases of papillitis with progressive and severe loss of vision.