THE COURSE OF VISUAL RECOVERY AFTER OPTIC NEURITIS - EXPERIENCE OF THE OPTIC NEURITIS TREATMENT TRIAL

Purpose: To define the time course of visual recovery after optic neur itis and factors predictive of this course in the patients enrolled in the Optic Neuritis Treatment Trial. Methods: The cohort for this stud y consisted of the 438 patients who completed the and month follow-up visit. Visual acuity was measured at baseline and at seven followup vi sits during the first 6 months. Factors predictive of recovery were ev aluated with univariate and multivariate statistical tests. Results: V isual recovery was rapid in all three treatment groups. In almost all patients, regardless of treatment group and initial severity of visual loss, improvement began within the first month. Among the 278 patient s with baseline visual acuity of 20/ 50 or worse, all patients improve d at least one line of visual acuity, and all except six improved at l east three lines, during the 6-month follow-up period. Baseline visual acuity was the best predictor of the and month visual acuity outcome (P = 0.0001). Older age was statistically associated with a slightly w orse outcome (P = 0.02), but this appeared to be of no clinical import ance. Conclusions: In most patients with optic neuritis, visual recove ry is rapid. The only factor of value in predicting the visual outcome is initial severity of visual loss. However, even when initial loss i s severe, visual recovery is still good in most patients. Patients not following the usual course of visual recovery should be considered at ypical. For such patients, further investigation in regard to etiology of the visual loss may be appropriate.