This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (90)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

One-Year Follow-up Results

Roy W. Beck, MD; Patricia A. Cleary, MS; Optic Neuritis Study Group

Arch Ophthalmol. 1993;111(6):773-775.

Abstract
• 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.

Interventions.
—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.

Author Affiliations
From the Department of Ophthalmology, University of South Florida College of Medicine, Tampa (Dr Beck), and the Biostatistics Center, George Washington University, Rockville, Md (Ms Cleary).

Footnotes
Accepted for publication April 9, 1993.

Reprint requests to Department of Ophthalmology, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd, MDC Box 21, Tampa, FL 33612 (Dr Beck).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The Optic Neuritis Treatment Trial: A Definitive Answer and Profound Impact With Unexpected Results
Volpe
Arch Ophthalmol 2008;126:996-999.
FULL TEXT  

Multiple Sclerosis Risk After Optic Neuritis: Final Optic Neuritis Treatment Trial Follow-up
The Optic Neuritis Study Group
Arch Neurol 2008;65:727-732.
ABSTRACT | FULL TEXT  

Optic Neuritis Associated With Chikungunya Virus Infection in South India
Mittal et al.
Arch Ophthalmol 2007;125:1381-1386.
ABSTRACT | FULL TEXT  

Visual function at baseline and 1 month in acute optic neuritis: Predictors of visual outcome
Kupersmith et al.
Neurology 2007;69:508-514.
ABSTRACT | FULL TEXT  

Clinical profile of simultaneous bilateral optic neuritis in adults
de la Cruz and Kupersmith
Br J Ophthalmol 2006;90:551-554.
ABSTRACT | FULL TEXT  

A double-blind, randomized trial of IV immunoglobulin treatment in acute optic neuritis
Roed et al.
Neurology 2005;64:804-810.
ABSTRACT | FULL TEXT  

The Natural History of Recurrent Optic Neuritis
Pirko et al.
Arch Neurol 2004;61:1401-1405.
ABSTRACT | FULL TEXT  

Correlation of MRI lesions with visual psychophysical deficit in secondary progressive multiple sclerosis
Caruana et al.
Brain 2000;123:1471-1480.
ABSTRACT | FULL TEXT  

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
Kaufman et al.
Neurology 2000;54:2039-2044.
FULL TEXT  

The National Eye Institute Visual Function Questionnaire: Experience of the ONTT
Cole et al.
IOVS 2000;41:1017-1021.
ABSTRACT | FULL TEXT  

Physicians, subsequence and consequence
McDonald
J. Neurol. Neurosurg. Psychiatry 1999;67:282-289.
FULL TEXT  

A randomized, controlled trial of oral high-dose methylprednisolone in acute optic neuritis
Sellebjerg et al.
Neurology 1999;52:1479-1479.
ABSTRACT | FULL TEXT  

Optic Neuritis in African Americans
Phillips et al.
Arch Neurol 1998;55:186-192.
ABSTRACT | FULL TEXT  

Visual Function 5 Years After Optic Neuritis: Experience of the Optic Neuritis Treatment Trial
The Optic Neuritis Study Group
Arch Ophthalmol 1997;115:1545-1552.
ABSTRACT  

Diabetic Papillopathy: Patient Characteristics and Fundus Findings
Regillo et al.
Arch Ophthalmol 1995;113:889-895.
ABSTRACT  

Ophthalmology
Levin
JAMA 1995;273:1703-1705.
ABSTRACT  

The Optic Neuritis Treatment Trial: Three-Year Follow-up Results
Beck and Optic Neuritis Study Group
Arch Ophthalmol 1995;113:136-137.
ABSTRACT  

10 Years: Over 10 000 Manuscripts
Goldberg
Arch Ophthalmol 1994;112:749-751.
ABSTRACT  

How Much Should We Editorialize?
Wilson
Arch Ophthalmol 1994;112:298-299.
ABSTRACT  

How Much Should We Editorialize?-Reply
Beck and Optic Neuritis Study Group
Arch Ophthalmol 1994;112:299-299.
ABSTRACT  

Pattern Visual Evoked Potentials in Treatment Trials for Optic Neuropathy
Brigell
Arch Ophthalmol 1994;112:299-300.
ABSTRACT  

High-Dose Corticosteroid Regimen Retards Development of Multiple Sclerosis in Optic Neuritis Treatment Trial
Trobe
Arch Ophthalmol 1994;112:35-36.
ABSTRACT  

The Effect of Corticosteroids for Acute Optic Neuritis on the Subsequent Development of Multiple Sclerosis
Beck et al.
NEJM 1993;329:1764-1769.
ABSTRACT | FULL TEXT