[Treatment of acute optic neuritis with high dose of prednisone].

OBJECTIVE

The benefit of glucocorticoid for the treatment of acute optic neuritis remains controversial. The efficacy of oral prednisone in 12 patients (14 eyes) with acute optic neuritis was reviewed.

METHODS

The time of visual symptoms before treatment was 3-15 days. The visual acuities were worse than 0.1 in all patients, with positive relative afferent pupillary defect. Visual field defect and delay latency of P100 in pattern VEP were also found. The regimen of glucocorticoid therapy was oral prednisone, starting with 160 mg daily followed by reducing the dosage by 20 mg every three days until 40 mg per day was attained and then tapering the dosage at 70 mg every other day until stoppage of the drug. The treatment was 3-11 months and 9 patients were followed up more than one year.

RESULTS

The visual acuities improved rapidly and stable. After 4 days, the visual acuity was 0.2 or better in 10 eyes. It was better than 0.6 in 12 eyes at 15 days. At 6 months, all had the visual acuity better than 0.7, with 85.7% equal or better than 1.0.

CONCLUSIONS

The regimen of oral prednisone beginning with 160 mg followed by tapering for three months would be feasible. Pattern VEP was a sensitive and credible sign for evaluating the extent of demyelination.