The mean duration of appearance of vision loss despite being on treatment varied from 4 weeks to 9 months. The patients with spinal arachnoiditis with myelitis showed worsening from 2 weeks to 6 months, and a paradoxical response was observed as late as 8 months in a few patients.
All these patients were treated with Thalidomide at the dose of 2-3 mg/ kg body weight (Range of 50-150 mg/ day), which was continued for an average of 6 months duration.
Of 59 patients with vision loss, 39 patients showed clinical improvement in visual acuity, while 21 out of 33 patients with spinal arachnoiditis showed clinical improvement, and 18 out of 27 patients showed either reduction or healing of tuberculomas after starting this immunomodulation. Baseline MRI in most patients (>95%) showed abnormalities in the form of arachnoiditis, tuberculomas, etc., which on 2-3-month follow-up Imaging showed worsening of radiological features and responded well after starting Thalidomide.