Optic neuritis treatment trial. One-year follow-up results
R. W. Beck and P. A. Cleary
Department of Ophthalmology, University of South Florida College of Medicine, Tampa 33612.
OBJECTIVE--To determine the efficacy of corticosteroids as treatment for
acute demyelinative optic neuritis after completion of 1 year of patient
follow-up in the Optic Neuritis Treatment Trial. DESIGN--Randomized placebo
controlled multicenter clinical trial. SETTING--Fifteen university or
hospital-based centers throughout the United States. PATIENTS--Four hundred
fifty-seven patients with acute demyelinative optic neuritis between 18 and
46 years of age. INTERVENTION--Either intravenous methylprednisolone sodium
succinate (250 mg every 6 hours) for 3 days followed by oral prednisone (1
mg/kg per day) for 11 days, oral prednisone (1 mg/kg per day) for 14 days,
or oral placebo for 14 days. The first two regimens were followed by a
short taper of corticosteroid therapy. MAIN OUTCOME MEASURES--Visual
acuity, visual field, contrast sensitivity, and color vision.
RESULTS--Visual acuity at 1 year was 20/40 or better in 95% of the placebo
group, 94% of the intravenous group, and 91% of the oral prednisone group.
Comparing each corticosteroid group with the placebo group, there were no
statistically significant differences in the distributions of any of the
four measures of visual function. Patients in the oral prednisone group
suffered a higher rate of new attacks of optic neuritis than patients in
either of the other two groups. CONCLUSIONS--The visual benefit from
treating acute optic neuritis with intravenous followed by oral
corticosteroids is short term, limited to an accelerated rate of recovery.
The decision whether to prescribe this regimen for optic neuritis, or to
prescribe no treatment, must be made for each patient on an individual
basis. Oral prednisone alone, in the dose range used in the Optic Neuritis
Treatment Trial, should not be prescribed.
The Optic Neuritis Treatment Trial: A Definitive Answer and Profound Impact With Unexpected Results
Volpe
Arch Ophthalmol 2008;126:996-999.
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Clinical profile of simultaneous bilateral optic neuritis in adults
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Correlation of MRI lesions with visual psychophysical deficit in secondary progressive multiple sclerosis
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Practice parameter: The role of corticosteroids in the management of acute monosymptomatic optic neuritis: Report of the Quality Standards Subcommittee of the American Academy of Neurology
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The National Eye Institute Visual Function Questionnaire: Experience of the ONTT
Cole et al.
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Physicians, subsequence and consequence
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Sellebjerg et al.
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Optic Neuritis in African Americans
Phillips et al.
Arch Neurol 1998;55:186-192.
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The Effect of Corticosteroids for Acute Optic Neuritis on the Subsequent Development of Multiple Sclerosis
Beck et al.
NEJM 1993;329:1764-1769.
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