Optic neuritis is diagnosable without any tests but MRI is key to treatment. Dr Morrow reviews key features such as:
- Hard exudates with disc swelling would NOT be optic neuritis
- Nor would presence if flame shaped heme
- 25% MS patients present with Optic Neuritis
- 50% ON patients develop MS
The speaker then discusses Optic Neuritis Treatment Trial (ONTT)
- Visual outcome whether treated or not
- Oral steroids didn’t help and had higher risk recurrence
- MRI extremely important in predicting risk MS
- Even a single lesion jumps the risk
- IV therapy cut recurrence risk for first two years
Other disease modifying meds like interferon and glatiramer were then discussed.
- These drugs are expensive, inconvenient, and are not without side effects
Optical Coherence Tomography (OCT) studies now (that we have Spectral Domain OCT) show the axonal loss.
Devic’s disease, neuromyelinitis optica, can present with multiple ON attacks before getting spinal cord disease