The presentation, aetiology, management and outcome of optic neuritis in an Asian population

Purpose: To analyse the presentation, aetiology, management and outcome of patients with optic neuritis (ON) in Singapore. Methods: This was a retrospective study involving consecutive patients with ON presenting at the Singapore National Eye Centre between January 1997 an d May 1999. The presenting features, investigations, treatment and visual o utcome after 6 months were studied. Results: A total of 31 patients (39 eyes) presented with ON during this per iod, 17 of whom had anterior ON. No aetiology was found in 26 patients (83. 9%), two patients (6.5%) had multiple sclerosis, one had active syphilis, o ne had rheumatoid arthritis and another had pan-sinusitis. Seventeen patien ts (54.8%) were treated with intravenous methyl-prednisolone followed by or al prednisolone. Within the follow-up period 26 of 31 eyes (83.9%) with idi opathic ON attained visual acuity of 6/12 or better, with 12 (38.7%) recove ring to 6/6 or better and only one eye ending with less than 6/60 visual ac uity. The one patient with syphilis recovered 6/6 visual acuity bilaterally . Both patients with multiple sclerosis also had good visual recovery at 6 months. The visual outcome in those cases of ON associated with rheumatoid arthritis and pan-sinusitis was poor with visual acuity of less than 6/60 a t 6 months follow up in each instance. Conclusion: The majority of the cases of ON in this study were idiopathic. There was a low association with multiple sclerosis. Most patients had good visual recovery within 6 months.