Abstract
To evaluate the clinical profile and visual outcome of optic neuritis patients presenting to a tertiary eyecare centre.It is a retrospective hospital-based study carried out over a period 5 years between 2013 to 2018 in a tertiary eyecare centre in South India. Case records of 20 patients diagnosed and treated for optic neuritis were evaluated based on clinical profile, type of presentation and visual outcome.Patients had a mean age was 34.7±13.5 years. 60% presented in age group of 20-40years. Male preponderance was seen (65% of cases). Papillitis (65% of eyes) was more common than retrobulbar neuritis (35% of eyes). Unilateral involvement was seen in 85% of cases with Bilateral presentation seen in only 15% cases. Baseline visual acuity in 10(43%) patients was in the range of Counting fingers to <6/60, 3(13%) patients had vision>= 6/60, 5(22%) patients had Hand movements positive and 5(22%) had Perception of light positive. Periocular pain was seen in 8(40%) of the cases. 13(56%) patients had defective colour vision. 16(70%) patients had Grade 3-4 RAPD while the remaining had grade 1-2 RAPD. One patient was diagnosed with multiple sclerosis (MS). Recurrence was seen in 1 patient (5%). After treatment with 3 doses of 1gm IV Methylprednisolone 15 patients (74% of eyes) showed improvement in vision, 7 eyes (35%) had improvement in colour vision, 4 eyes (20%) had improvement in pupillary reaction after 3 doses of IV Methylprednisolone.Optic neuritis is idiopathic in nature. Papillitis is the commonest presentation when compared to Retrobulbar neuritis.
Highlights
Optic neuritis (ON) is an acute inflammatory disorder of the optic nerve. It presents as sudden onset diminution of vision and may be unilateral or bilateral with or without associated periocular pain. 1,2 As a rule most cases present between 15-45 years of age. 3,4 Clinically patients present with decreased visual acuity, relative afferent pupillary defect, decreased contrast sensitivity and dyschromatopsia
Initial vision on presentation were as follows: 3(13%) eyes had vision >= 6/60, 10(43%) eyes had in range of CF to
7(30%) eyes presented with Grade 1-2 RAPD or ill sustained pupillary reaction and 16(70%) eyes had grade 3-4 RAPD pupillary reaction (Figure 5)
Summary
Optic neuritis (ON) is an acute inflammatory disorder of the optic nerve. It presents as sudden onset diminution of vision and may be unilateral or bilateral with or without associated periocular pain. 1,2 As a rule most cases present between 15-45 years of age. 3,4 Clinically patients present with decreased visual acuity, relative afferent pupillary defect, decreased contrast sensitivity and dyschromatopsia. In the western countries Multiple sclerosis is most common etiology.[4] Our hospital being the regional institute of the state has patient input from all over the state being referred by other hospitals. This study was done to examine and evaluate the clinical profile and visual outcome of optic neuritis (ON) patients presenting to our hospital
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