Abstract
Optic neuritis, inflammation of the optic nerve, can cause visual impairment through retinal nerve fiber layer (RNFL) degeneration. Optical coherence tomography could serve as a sensitive noninvasive tool for measuring RNFL thickness and evaluating the neuroprotective effects of treatment. We conducted a meta-analysis to compare RNFL loss between novel add-on treatments and corticosteroid therapy at least 3 months after acute optic neuritis. The outcome measures were mean differences (MDs) in (1) RNFL thickness compared with the baseline in the affected and unaffected eye and (2) LogMAR visual acuity (VA). Seven studies involving five novel agents (memantine, erythropoietin, interferon-beta, phenytoin, and clemastine) were analyzed. When compared with the baseline RNFL thickness of the affected eye, the neuroprotective effects of novel add-on treatments could not be demonstrated. The difference in visual outcomes was also not significant between the two treatment groups. One study revealed that phenytoin has the potential to alleviate RNFL loss when the baseline thickness of the unaffected eye is considered. Larger randomized controlled trials with suitable outcome measures are warranted to evaluate the neuroprotective effects of novel treatments. Further studies should also tailor therapies to specific patient populations and investigate a more targeted treatment for acute optic neuritis.
Highlights
Optic neuritis, which can be clinically divided into typical and atypical forms, refers to inflammation of the optic nerve that can cause vision impairment through the degeneration of the optic nerve and retinal nerve fibers
Typical optic neuritis is a demyelinating disorder of the optic nerve that is often associated with multiple sclerosis (MS), whereas atypical optic neuritis involves inflammatory, infectious, or autoimmune etiologies [1,2]
Sion does not recover after an acute episode, reduced mobility may ensue, creating a considerable socioeconomic burden
Summary
Optic neuritis, which can be clinically divided into typical and atypical forms, refers to inflammation of the optic nerve that can cause vision impairment through the degeneration of the optic nerve and retinal nerve fibers. The two cardinal symptoms of typical optic neuritis are unilateral vision loss and painful eye movement. Visual loss develops in hours or days, and the onset of eye pain usually coincides with it. Other symptoms include visual field (VF) loss, dyschromatopsia, and decreased contrast sensitivity. Atypical optic neuritis generally occurs bilaterally, and its clinical manifestations are more severe. Certain features, such as pronounced disc swelling, peripapillary hemorrhages, and macular exudates, are indicative of atypical optic neuritis. Visual impairment may become profound and not improve [1,2]
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