Optic neuritis: Prognosis and treatment
- Benjamin Osborne, MD
Benjamin Osborne, MD
- Assistant Professor
- Georgetown University Hospital
- Laura J Balcer, MD, MSCE
Laura J Balcer, MD, MSCE
- Professor of Neurology, Population Health and Ophthalmology
- Vice Chair, Department of Neurology
- NYU Langone Medical Center
- Section Editors
- Francisco Gonzalez-Scarano, MD
Francisco Gonzalez-Scarano, MD
- Section Editor — Multiple Sclerosis, Neurovirology & NeuroAIDS
- John P. Howe, III, MD, Distinguished Chair in Health Policy
- The University of Texas Health Science Center at San Antonio
- Paul W Brazis, MD
Paul W Brazis, MD
- Section Editor — Neuroophthalmology
- Professor of Neurology, Department of Ophthalmology
- Mayo Clinic College of Medicine
Optic neuritis is an inflammatory, demyelinating condition that causes acute, usually monocular, visual loss. It is highly associated with multiple sclerosis (MS), occurring in 50 percent of individuals at some time during the course of their illness [1-4]. Optic neuritis is the presenting feature of MS in 15 to 20 percent of patients.
The prognosis and treatment of demyelinating optic neuritis will be reviewed in this topic. The epidemiology, pathophysiology, clinical features, and diagnosis of optic neuritis are discussed separately. (See "Optic neuritis: Pathophysiology, clinical features, and diagnosis".)
The term optic neuritis is sometimes applied to other inflammatory and infectious conditions affecting the optic nerve. These and other causes of optic neuropathy and the management of multiple sclerosis are discussed separately. (See "Optic neuropathies" and "Treatment of progressive multiple sclerosis in adults" and "Treatment of relapsing-remitting multiple sclerosis in adults" and "Clinically isolated syndromes suggestive of multiple sclerosis" and "Diagnosis of multiple sclerosis in adults", section on 'Neuromyelitis optica'.)
Prognostic concerns in patients with optic neuritis are visual recovery, recurrence of optic neuritis, and risk of multiple sclerosis (MS).
Recovery of vision — Without treatment, vision begins to improve after a few weeks . Improvement can continue over many months; 90 percent have 20/40 or better vision at one year. Some patients may have a more or less favorable prognosis:
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