Visual function more than 10 years after optic neuritis: experience of the optic neuritis treatment trial

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Abstract

Purpose

To assess visual function more than 10 years after an episode of optic neuritis in patients enrolled in the Optic Neuritis Treatment Trial.

Design

Longitudinal follow-up of a randomized clinical trial.

Methods

Vision testing included measures of visual acuity, contrast sensitivity, and visual field. Quality of life was assessed with the National Eye Institute Visual Function Questionnaire.

Results

Examinations were completed on 319 patients. In most patients, visual function test results in the eyes that experienced optic neuritis at study entry (“affected eyes”) were normal or only slightly abnormal after 9.9 to 13.7 years. Visual acuity in the affected eyes was ≥20/20 in 74%, 20/25 to 20/40 in 18%, <20/40 to 20/200 in 5%, and <20/200 in 3%. On average, visual function was worse in patients with multiple sclerosis (MS) than in those without MS. Recurrent optic neuritis in either eye occurred in 35% of patients. Such attacks were more frequent in patients with MS (P < .001). The National Eye Institute Visual Function Questionnaire scores were lower when visual acuity was abnormal and when MS was present.

Conclusions

Most patients retained good to excellent vision more than 10 years after an attack of optic neuritis. Recurrences were more frequent in patients with MS.

Section snippets

Methods

Between June 1988 and July 1991, 454 patients with optic neuritis were enrolled into the ONTT and completed the baseline testing (one enrolled patient withdrew before completing the baseline testing, and two patients were found to have a compressive optic nerve lesion rather than optic neuritis). Patients provided written informed consent for each follow-up phase. After the conclusion of the treatment trial in 1992, 410 patients consented to continued follow-up, and in 1997, 387 patients again

Results

An examination was completed for 319 (82%) of the 387 patients who consented to continue in follow-up beyond 1997. The time from entry into the ONTT until the examination ranged from 9.9 to 13.7 years. For 272 patients (85%), the examination was completed at one of the original ONTT clinical centers. The remaining 47 patients (15%) completed the examination with a nonstudy ophthalmologist, because returning to an ONTT clinical center was not feasible.

Among the 454 patients in the original ONTT

Discussion

Continued follow-up of the cohort of patients who were enrolled into the ONTT has provided a unique opportunity to assess the long-term course of vision after an episode of acute optic neuritis. We found that in most patients, once visual acuity stabilized after the initial episode of optic neuritis (as determined from the acuity measurement 1 year after the episode), it remained remarkably stable for more than 10 years. After 10 years, 69% of patients had acuity of 20/20 or better in each eye,

References (13)

  • P.A. Cleary et al.

    Design, methods, and conduct of the Optic Neuritis Treatment Trial

    Control Clin Trials

    (1993)
  • Optic Neuritis Study Group. High and low risk profiles for the development of multiple sclerosis within ten years after...
  • R.W. Beck et al.

    A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis

    N Engl J Med

    (1992)
  • R.W. Beck et al.

    The effect of corticosteroids for acute optic neuritis on the subsequent development of multiple sclerosis

    N Engl J Med

    (1993)
  • The clinical profile of acute optic neuritis. Experience of the Optic Neuritis Treatment Trial

    Arch Ophthalmol

    (1991)
  • Visual function five years after optic neuritisexperience of the Optic Neuritis Treatment Trial

    Arch Ophthalmol

    (1997)
There are more references available in the full text version of this article.

Cited by (0)

This study was supported by a Cooperative Agreement (U10 EY09435) from the National Eye Institute, National Institutes of Health.

*

The writing committee, investigators, and coordinators who participated in the study are listed in the Appendix.

e1

[email protected]

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