Optic Neuritis Treatment Trial Review: 10 year and 15 year (final) results

Optic Neuritis – ONTT [10 Years Post] Treatment – IV methylprednisone (1000mg/day x 3 days – Followed by oral prednisone (1mg/kg/day x 14 days) Recovery – Usually recovers VA in about half of the time. Tx v. un-Tx end point is the same. Prognosis – With IV, significantly lower rate of developing MS, and fewer (and less intense) ON attacks. General risk is 38% at 10 year follow-up. Recovery – Strongest indicator of developing MS No MRI lesions: 22% 1 or more lesions: 56%

An Article We Should ALL Read and Be Aware Of… From: Arch Ophthalmol. Vol 121, pp July 2003

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Gender and Optic Disc Appearance as Predictors of MS

Summary of Results of the ONTT Status Post 10 Years – 10 year (overall) risk of MS was 38% – Patients who had 1 or more typical lesions with MRI had a 56% risk – Those with no lesions had a 22% risk – Lower Risk Factors: No MRI lesions Male No pain ONH swelling

Summary of Results of the ONTT Status Post 15 Years The main conclusions of the 15-year data include: – Visual recovery after optic neuritis was excellent, with > 92% of patients improving to > 20/40 vision. – However, most of these patients still complain that they have reduced visual quality of life; and

Summary of Results of the ONTT Status Post 15 Years Overall, 50% of patients converted to clinically definite MS by 15 years (38% at 10 years). – The risk of developing MS was 25% when baseline MRI was normal – The risk of developing MS was 75% when MRI had 1 or more brain lesions typical for MS. The risk of MS was extremely low in those patients with a normal MRI who were male, with optic nerve swelling or atypical features of optic neuritis.

Summary of Results of the ONTT Status Post 15 Years The main conclusions of the 15-year data include: – Visual recovery after optic neuritis was excellent, with > 92% of patients improving to > 20/40 vision. – However, most of these patients still complain that they have reduced visual quality of life; and

Summary of Results of the ONTT Status Post 15 Years Overall, 50% of patients converted to clinically definite MS by 15 years (38% at 10 years). – The risk of developing MS was 25% when baseline MRI was normal – The risk of developing MS was 75% when MRI had 1 or more brain lesions typical for MS. The risk of MS was extremely low in those patients with a normal MRI who were male, with optic nerve swelling or atypical features of optic neuritis.