Purpose
To find the visual outcome predictors in patients who received intravenous steroid pulse therapy (ISPT) due to acute optic neuritis (AON).
Methods
A retrospective, observational, clinical study. A total of 33 AON patients received ISPT (methylprednisolone, 250 mg, four times a day, 3 days) and had follow-up checkups for at least 3 months after the therapy were included in this study. Patients were divided into two groups, those who finally recovered their vision over LogMAR 0.3 (Group 1, n=25) vs. those who didn’t (Group 2, n=8). We evaluated the demographics and clinical characteristics and tried to determine which factors had affected the visual outcome.
Results
The presence of a relative afferent pupillary defect (RAPD) and a pattern of visual field (VF) defect at presentation, and the degree of visual loss at the 3 month and 1 year after treatment were associated to the final visual outcome. While, age, gender, bilaterality, moving pain, headaches, and the degree of vision and color sense loss were not related to the final visual outcome. The presence of disc swelling and retinal nerve fiber layer (RNFL) defect, the abnormal responses on visual evoked potential (VEP), the abnormal level of erythrocyte sedimentation rate (ESR) and/or C-reactive protein (CRP) were also not associated with the final visual outcome.
Conclusions
At presentation, the RAPD and VF defect excluding visual loss were associated with the final visual outcome in AON patients who had received ISPT. Regarding vision, the visual acuity at 3 months and 1 year after treatment were associated with the final visual outcome.