Clinical prospective study of visual function in patients with acute optic neuritis.

Background/purpose: To investigate the clinical features and visual outcomes of acute optic neuritis in adult patients.

Methods: We prospectively collected ninety-nine adult patients, who were found to have acute optic neuritis between 2005 and 2007 at National Taiwan University Hospital. A total of 30 cases, aged ranging from 21 to 55 years old (average 36.4 ± 9.9), that followed up at least 6 months were enrolled in our study. Baseline clinical features and visual function results were analyzed.

Results: The mean follow-up period was 15.6 months. Twenty three (76.7%) cases were female. Twenty-seven cases were unilateral involved, one was simultaneously bilateral involved and two was sequentially bilateral involved. In total 33 affected eyes, ocular or periocular pain was noted in 14 eyes (69.7%). Optic disc swelling was noted in 5 eyes (15.2%). A total of 6 cases had recurrent episodes, and two of them were diagnosed with multiple sclerosis thereafter. At 6-month follow up, 24 eyes (72.7%) had good visual recovery (better than 20/40). Only 2 eyes (6%) had severe visual loss (<20/1000). Optic disc pale was detected in 72.7% of the eyes during follow up.

Conclusion: Visual recovery was observed in most eyes with acute optic neuritis, although disc pale detectable. Patients with recurrent optic neuritis had worse visual outcome. There was a low association of optic neuritis with multiple sclerosis in our patients.