Later course and prognosis of optic neuritis

The study was a re-examination of 176 patients with optic neuritis. The follow-up period was for 38 patients, 6-12 months, for 52 patients, 1-5 years and for 86 patients, 6-24 years from the initial attack of optic neuritis. In 66% of the involved eyes visual acuity had again become good or excellent, but in 25% it was poor. The visual field was normal in only 38%, in 30% there was an absolute or relative central defect and in 31% a paracentral or peripheral defect. Recurrent attacks of optic neuritis occurred in one fourth of the patients and was a common finding in MS patients. Nineteen per cent of the eyes had suffered from more than one attack. Visual acuity was good or excellent in more than half, but the visual field was normal in only 29% of the eyes with more than one attack of optic neuritis. The frequency of bilateral involvement was high at the end of the follow-up period, 44% of patients had both eyes involved by optic neuritis. In 47 patients the initial attack was bilateral optic neuritis and 34% of these patient had permanently poor vision in both eyes. The initial attack was unilateral in 30 patients but the other eye became involved later. In 26% of all patients with bilateral involvement, visual acuity was permanently poor in both eyes. Bilateral papillitis was a common manifestation in young patients and in this age group the disease had a tendency towards good recovery.