Intravenous Methylprednisolone and Oral Prednisone for Optic Neuritis

Optic neuritis, a condition affecting the optic nerve, often impacts young adults and is more common in women. It's the second most prevalent acquired optic nerve disorder in people under 50. While visual recovery is typically good, it's seldom complete, and patients usually show signs of optic nerve damage afterwards. Before the Optic Neuritis Treatment Trial (ONTT), there were no established guidelines for treating this condition. The ONTT is important because it aims to find effective treatments and understand the link between optic neuritis and multiple sclerosis, as optic neuritis can be the first sign of MS or occur later in its course. In this study, participants are randomly assigned to one of three treatment groups at 15 clinical centers in the US. The groups receive either oral prednisone for 14 days, intravenous methylprednisolone for 3 days followed by oral prednisone for 11 days, or a placebo for 14 days. Each treatment is followed by a short oral taper. The study measures visual recovery and long-term visual outcomes through tests of visual acuity, contrast sensitivity, color vision, and visual field at baseline, seven follow-up visits in the first 6 months, and then yearly. A standardized neurological examination is also conducted at baseline, after 6 months, and then annually.