Optic neuritis in the elderly: prognosis for visual recovery and long-term follow-up

We evaluated 14 patients with idiopathic optic neuritis, 50 years of age or older, within 1 month of symptomatic onset from 1980 through 1985. We obtained follow-up information from case records an average of 13 months after initial examination and from telephone interviews an average of 57 months after initial evaluation. Four patients were men and ten were women. Visual loss was monocular in ten cases and binocular in four. Only one of 18 affected eyes initially had an acuity of 20/30 or better. Eleven eyes recovered acuities of 20/30 or better. There was no apparent benefit to those patients treated with corticosteroid agents. Six patients (43%) developed other neurologic sequelae an average of 16 months later; four (28%) had a second bout of optic neuritis and three (21%) developed clinically definite MS. Optic neuritis in the elderly behaves similarly to that disorder in younger age groups.