Autoimmune optic neuritis: a potentially treatable form of visual loss

In most patients, idiopathic optic neuritis remits spontaneously. Among those in whom it does not are patients with systemic lupus erythematosus, who often respond to pulse methylprednisolone. This subset of patients may be expanded to patients with other autoimmune phenomena, as in the case of a young woman who had myasthenia gravis and other laboratory evidence of autoimmunity. She had permanently lost vision in the right eye without treatment of optic neuritis, but in a later similar episode the left eye responded to pulse methylprednisolone after failing to respond to orally administered prednisone.