Management of acute optic neuritis

Lancet. 2002 Dec 14;360(9349):1953-62. doi: 10.1016/s0140-6736(02)11919-2.


Optic neuritis is a common condition that causes reversible loss of vision. It can be clinically isolated or can arise as one of the manifestations of multiple sclerosis. Occasional cases are due to other causes, and in these instances management can differ radically. The treatment of optic neuritis has been investigated in several trials, the results of which have shown that corticosteroids speed up the recovery of vision without affecting the final visual outcome. Other aspects of management, however, are controversial, and there is uncertainty about when to investigate and when to treat the condition. Here we review the diagnostic features of optic neuritis, its differential diagnosis, and give practical guidance about management of patients. The condition's association with multiple sclerosis will be considered in the light of studies that define the risk for development of multiple sclerosis and with respect to results of trials of disease-modifying drugs in these individuals.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / etiology*
  • Optic Neuritis* / complications
  • Optic Neuritis* / diagnosis
  • Optic Neuritis* / drug therapy
  • Randomized Controlled Trials as Topic
  • Risk Factors


  • Adrenal Cortex Hormones