Treatment of Optic Neuritis

Treatment

Patients with optic neuritis of undetermined cause or that related to multiple sclerosis have a self limiting course. Vision recovers completely or partially over weeks to months. The visual recovery can be hastened with the use of steroids.

Steroids are given intravenously i.e. injected slowly into a vein, for three days under strict supervision by a doctor in the hospital. This is followed by oral dose for 11 days. This form of treatment hastens recovery but the end result at one year follow up is the same as no treatment given in terms of visual recovery.

Oral steroids alone are contraindicated as it increases the rate of recurrence.

Interferon therapy has proven benefit in reducing the incidence of multiple sclerosis in patients with optic neuritis. Interferon injections once weekly have shown reduced incidence and morbidity from multiple sclerosis in patients with demyelinating episode like optic neuritis.

References:

1. Neil R, Miller, Fletcher Hoyt �Walsh & Hoyt�s clinical neuroophthalmology.�2005: 293-317
2. Beck, R.W., Cleary, P.A., et al. "Optic Neuritis Treatment Trial." Arch Ophthalmol�3 (1993): 773-775.
3. Nikoskelainen, E. "Symptoms, signs and early course of optic neuritis."�Acta Ophthalmol�53 (1975): 254.
4. Wray, S.H. "Optic Neuritis."�Principles and Practice of Ophthalmology, volume 4, 2539-2568.
5. Ankur Sinha �Optic Neuritis� DOS Times, 16/ Dec 2010, 11-18

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