_Optic Neuritis Treatment Trial ONTT 视神经炎治疗试验课件.ppt

Without MRI findings At 5 years ----- 16% At 10 years ----- 22% At 15 years ------ 25% Only 3% increased risk after 10 years With MRI findings At 5 years ----- 37% with 1-2 lesions ------ 51% with ≥ 3 lesions At 10 years ------ 56% with ≥ 1 lesion At 15 years ------ 75% with ≥ 1 lesion 20% increased risk after 10 years Protective factors Male gender Optic nerve head swelling [ papillitis ] Atypical presentation severe optic disc swelling Disc or peripapillary haemorrhages Retinal exudates Absent pain Vision no PL Brief Bibliography PN Shams, GT Plant. Optic Neuritis: A Review The International MS Journal 2009; 16: 82–89 Multiple Sclerosis Risk after Optic Neuritis: Final Optic Neuritis Treatment Trial Follow-Up. The Optic Neuritis Study Group*. Arch Neurol. 2008 June ; 65(6): 727–732. The Clinical Profile of Optic Neuritis. Experience of the Optic Neuritis Treatment Trial. Optic Neuritis Study Group. Arch Ophthalmol. 1991;109:1673-1678 Roy W. Beck, Robin L. Gal, Treatment of Acute Optic Neuritis. A Summary of Findings From the Optic Neuritis Treatment Trial. ARCH OPHTHALMOL/VOL 126 (NO. 7), JULY 2008 Long-term Brain Magnetic Resonance Imaging Changes After Optic Neuritis in Patients Without Clinically Definite Multiple Sclerosis Optic Neuritis Study Group. Arch Neurol. 2004;61:1538-1541 ONTT The results of the ONTT are applicable to monocular demyelinating typical optic neuritis Beware of applying these results to all cases presenting with “optic neuritis” In general, the visual outcome is usually good irrespective of treatment The MRI (T-2 weighted 1.5 Tesla ) is an extremely important prognosticator for future MS The Optic Neuritis Treatment Trial ( ONTT ) R.R.Battu Narayana Nethralaya Bangalore Classical Demyelinating Optic Neuritis Young adults between 20 and 45 years F:M = 3:1 Monocular retro ocular pain particularly on eye movement (? Upward) Followed several hours or a few days