Optic neuritis 4 of 4
Complications
Complications arising from optic neuritis may include:
· Optic nerve damage. Most people have permanent optic nerve damage following an episode of optic neuritis, but they may not experience any symptoms.
· Decreased visual acuity. Vision loss may persist after optic neuritis has improved. About 20 percent of people with optic neuritis have some degree of long-term vision loss.
· Side effects of treatment. Steroid medications used to treat optic neuritis subdue your immune system, which causes your body to become more susceptible to infections. Long-term use of steroids may also cause thinning of your bones (osteoporosis).
Treatment
Optic neuritis usually gets better on its own. In some cases, steroid medications are used to treat optic neuritis, because they help reduce inflammation in the optic nerve. If you receive steroids, your treatment may involve:
· Intravenous steroids. You'll likely receive steroid therapy by vein (intravenously) for several days. Intravenous steroid therapy may accelerate vision recovery, but it doesn't appear to affect the extent to which you'll recover your vision.
· Oral steroids. After intravenous steroid therapy, you may take an oral steroid called prednisone for several weeks. Oral steroids usually follow an intravenous course of steroids, because using oral steroids alone to treat optic neuritis has been associated with an increased risk of recurrence.
In instances in which steroid therapy has failed and severe vision loss persists, a treatment called plasma exchange therapy may help some people recover their vision.
Preventing progression of multiple sclerosis
If you have optic neuritis and you're at high risk of developing multiple sclerosis, you may benefit from drugs that help prevent the progression of multiple sclerosis.
These drugs include interferon beta-1a (Avonex, Rebif) and interferon beta-1b (Betaseron) Glatiramer Acetate (Copaxone) and Natalizumab (Tysabri). These injectable drugs are used to prevent or delay the development of multiple sclerosis in people with optic neuritis who have two or more brain lesions evident on MRI scans.
Prognosis
The prognosis following optic neuritis is generally good. Most people regain normal vision two to six months after an episode of optic neuritis. However, people with multiple sclerosis or neuromyelitis optica may experience recurrent attacks of optic neuritis sometime after they've recovered from the initial episode. Other people without any underlying conditions also may have recurrent optic neuritis; these people have a better prognosis for their vision in the long term than do people with neuromyelitis optica.