Treatment and Prognosis
In most cases, visual functions return to near normal within eight to ten weeks, but they may also advance to a complete and permanent state of visual loss. Therefore, systemic intravenous treatment with corticosteroids, which may quicken the healing of the optic nerve, is often recommended. It does not, however, have a significant effect on the visual acuity at one year when compared against placebo. Intravenous corticosteroids have also been found to reduce the risk of developing MS in the following two years in those patients who have MRI lesions; but this effect disappears by the third year of follow up.
Paradoxically it has been demonstrated that oral administration of corticosteroids in this situation may lead to more recurrent attacks than in non-treated patients (though oral steroids are generally prescribed after the intravenous course, to wean the patient off the medication). This effect of corticosteroids seems to be limited to optic neuritis and has not been observed in other diseases treated with corticosteroids.
Very occasionally, if there is concomitant increased intracranial pressure, the sheath around the optic nerve may be cut to decrease the pressure.
When optic neuritis is associated with MRI lesions suggestive of multiple sclerosis (MS) then general immunosuppressive therapy for MS is often prescribed (IV methylprednisolone may shorten attacks).
Read more about this topic: Optic Neuritis
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