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Acute Optic Neuritis.

Kaufman1

  • 1Center for Clinical Neuroscience and Ophthalmology, A-217 Michigan State University Clinical Center, Colleges of Osteopathic and Human Medicine, 138 Service Road, E. Lansing, MI 48823, USA.

Current Treatment Options in Neurology
|November 30, 2000
PubMed
Summary
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Avoid oral prednisone alone for acute optic neuritis. Intravenous methylprednisolone followed by oral prednisone offers better outcomes, especially with MRI evidence of demyelination or urgency for faster visual recovery.

Area of Science:

  • Neurology
  • Ophthalmology

Background:

  • Acute monosymptomatic optic neuritis (A MON) requires careful treatment considerations.
  • Oral prednisone monotherapy is generally not recommended for A MON.

Purpose of the Study:

  • To evaluate optimal treatment strategies for acute monosymptomatic optic neuritis.
  • To determine the utility of magnetic resonance imaging (MRI) in prognosis and differential diagnosis.

Main Methods:

  • Comparison of treatment protocols for A MON.
  • Assessment of MRI findings in predicting multiple sclerosis (MS) development.
  • Evaluation of the necessity for ancillary tests like chest x-ray, blood tests, and lumbar puncture.

Main Results:

  • Intravenous methylprednisolone followed by oral prednisone is preferred over oral prednisone alone for A MON.

Related Experiment Videos

  • MRI showing three or more demyelinating signal abnormalities warrants consideration of this intensified steroid regimen.
  • MRI is valuable for prognosis in patients without a diagnosis of clinically definite multiple sclerosis (CDMS).

    • Conclusions:

    • Intravenous methylprednisolone followed by oral prednisone is a recommended treatment for A MON, particularly when rapid visual recovery is desired or MRI shows significant demyelination.
    • MRI aids in assessing MS prognosis and ruling out other optic neuropathies.
    • Ancillary tests are generally not necessary for typical A MON cases but may be considered before corticosteroid therapy.