June 2, 2008 What are the long term vision consequences when a person has an acute attack of optic neuritis, a sudden-onset eye disease of the nerves that carry visual signals to the brain? Are the consequences different if the person is treated with corticosteroids, or if the patient's attack is complicated by having multiple sclerosis (MS)?
The Optic Neuritis Study Group recently conducted a 15-year follow-up study of 454 patients who had acute optic neuritis--a disorder that is often the first sign of MS---in one eye and who participated in the Optic Neuritis Treatment Trial (ONTT), a 1988 -- 1991 randomized clinical trial. Optic neuritis causes symptoms such as blurred vision, blind spots, dimmed colors and sometimes eye pain.
The researchers concluded that ophthalmologists (Eye MDs) can advise acute optic neuritis patients that the "long-term outlook for their vision is favorable," even if they currently have or develop MS. Of the original ONTT study cohort, 294 patients completed the follow-up exam in 2006. Seventy-two percent of patients had 20/20 vision or better in the affected eye and 66 percent had 20/20 or better vision in both eyes. Mild decreases in vision (20/25 to 20/40) were attributed to lens changes in nine patients, which would be expected in an age group with an average age of 48, the life-stage when the eye's lens becomes less flexible and many people need reading glasses. Long-term vision quality was similar among patients who were treated with high-dose intravenous corticosteroids and patients who were not, although the initial recovery period was shorter for treated patients.
Even though their vision was found to be normal about 60 percent of the time, the patients with MS were more likely to report somewhat reduced quality-of-life, including: difficulty with daily tasks like parking a car and using a computer, and problems such as double vision and trouble focusing on moving objects.
This research was published in the June 2008 issue of Ophthalmology.
The study was funded by the National Eye Institute of the National Institutes of Health.
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