Visual outcome following optic neuritis: a 5-year review

Abstract

Background: Optic neuritis is a demyelinating inflammatory disease of the optic nerve that typically affects young adults especially females, and is usually associated with multiple sclerosis especially in Caucasians. The prognosis for visual recovery is usually good but with poor quality.

Objective: The objective was to determine the level of improvement of vision after an attack of optic neuritis in Port Harcourt, Nigeria.

Design: A retrospective hospital-based study was performed.

Setting: Eye Clinic, University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria.

Data extraction: Medical records of all cases of optic neuritis seen at the Eye Clinic of UPTH over a 5-year period (January 2006-December 2010) were retrieved and relevant data including age, sex, presenting symptom, and visual acuity (VA) were extracted. The VA at discharge 12 weeks later was noted. Our diagnosis of optic neuritis was based on the presence of low vision, dyschromatopsia, and peri-ocular pain.

Results: Over 24,000 patients were seen during this period, and 27 cases were optic neuritis (0.1%). Of the 27 cases of optic neuritis, 20 cases were retro-bulbar neuritis (74.1%), while seven (25.9%) were papillitis. There were 16 females and 11 males giving a female to male ratio of 3:2. Most cases (75%) at presentation had VAs<6/24. By the 12 th week, most visual acuities (77.1%) had improved to 6/12 or better.

Conclusion: This study confirms widely documented evidence that there is improvement in visual acuity after an attack of optic neuritis. Even though the risk of developing multiple sclerosis following optic neuritis is said to be low in blacks, these patients should still be followed up for sometime especially as some may go on to develop other complications of demyelination.