Optic neuritis: a review.

摘要: Acute demyelinating optic neuritis (ON) is the initial presentation in approximately 20% of cases multiple sclerosis (MS) and characterized by unilateral, subacute, painful visual loss without systemic or neurological symptoms. The Optic Neuritis Treatment Trial (ONTT) has provided valuable insights into both natural history clinical course ON with respect to treatment. Visual function improves spontaneously over weeks within 12 months 93% have recovered a acuity at least 20/40. high-dose corticosteroids may accelerate recovery, but little impact on long-term outcome. In ONTT 10-year risk recurrence was 35%. presence white matter lesions magnetic resonance image brain been identified as strongest predictor for development MS. 15-year developing MS 25% no lesions, 75% one more lesions. Since there evidence early axonal damage acute ON, disease-modifying drugs should be considered patients high future prophylaxis against permanent impairment.