[Diagnosis, treatment and prognosis of optic neuritis]

ABSTRACT

Optic neuritis occurs in young patients, most often females, and presents as subacute monocular visual loss. Periocular pain, particularly with eye movement occurs in the majority of cases. The retrobulbar form occurs in 65% of cases and is associated with normal optic disc appearance at onset. The central visual field is usually affected and an RAPD and dyschromatopsia are present. Brain magnetic resonance imaging [MRI] is recommended in all cases of optic neuritis. Evaluation for periventricular white matter lesions is the single best test for assessing the risk of future multiple sclerosis [MS]. Typical idiopathic neuritis begins to show improvement within one month, the use of intravenous methylprednisolone 250 mg every 6 hours for 3 days, followed by oral prednisolone 1 mg/kg/ day for 11 days speeds recovery by 1 to 2 weeks. Oral prednisolone alone has shown no benefit, has been associated with an increased risk of recurrence and its use is not recommended