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Optic Neuritis (cont.)

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What is the prognosis for optic neuritis?

The prognosis depends on the underlying cause. Most episodes resolve spontaneously, with return of vision in two weeks to three months. About 90% of people with optic neuritis will recover most of their vision within six months of onset. However, about 14% will have a recurrence of optic neuritis in the affected eye, and 12% will develop optic neuritis in the other eye within 10 years. If the patient has one or more abnormal lesions on the MRI, the risk of MS within 15 years is 72%.

Is it possible to prevent optic neuritis?

Since almost 50% of optic neuritis is likely a result of a post-viral immune reaction, minimizing your risk of acquiring a viral respiratory infection decreases your risk of optic neuritis. It is impossible to totally avoid exposure to respiratory viruses, but research has shown that frequent hand-washing and attempting to not touch one's face without first washing one's hands decreases the incidence of the common cold. Teaching children to cover their mouths and noses when sneezing and instructing them on personal hygiene can also decrease the chances of upper respiratory virus spreading within families.

In patients with recurrent optic neuritis secondary to multiple sclerosis, there are approved disease-modifying agents that reduce disease activity and disease progression for many people with relapsing forms of MS, including relapsing-remitting MS, as well as progressive forms of MS in those people who experience relapses. These include injectable forms of interferon beta, glatiramer acetate, and the biologic monoclonal antibody, daclizumab. Oral medications include teriflunomide (Aubagio), fingolimod (Gilenya), and dimethyl fumarate.

Relapses of multiple sclerosis are sometimes treated with a three- to five-day course of intravenous high-dose corticosteroids such as methylprednisolone. Similar to the use of this regimen in treating acute optic neuritis, intravenous corticosteroids will often end the relapse more rapidly but does not have any effect on the long-term outcome of the disease.

Medically Reviewed by a Doctor on 10/31/2017


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