Clinical profile and short term outcomes of optic neuritis patients in India

1. Rohit Saxena¹
2. Swati Phuljhele¹
3. Vimla Menon¹
4. Pradeep Sharma¹

¹Neuro-Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

Purpose: To evaluate the clinical profile and short term outcomes of optic neuritis patients in India.

Methods: In a prospective study carried out over a period of 3 years, 99 eyes of 83 optic neuritis patients were examined and followed up. Type of presentation, recurrence rate and improvement in vision were noted. Detailed history was taken with complete ophthalmic and neurological evaluation. Investigations done included visual field assessment, Visual Evoked Potentials, contrast sensitivity and color vision. MRI was done wherever possible.

Results: The mean age of presentation was 27.4± 8.8 years with a female preponderance (70%). Papillitis and retrobulbar neuritis were equally common with bilateral presentation seen in 19.3% cases. Pain was an accompanying feature in 61 cases (73.4%). Baseline median logMAR vision was 1.6± 0.8 which improved to 0.2± 0.6 with approximately 64% of eyes retaining a vision of 20/40 or more. In unilateral cases 19.5% showed subclinical involvement of the other eye. Multiple sclerosis (MS) was diagnosed in 4 cases. Recurrence was seen in 18% of patients and was more common in cases of retrobulbar neuritis.

Conclusion: The clinical profile of optic neuritis in Indian patients appears to be different. Unlike reported in western literature, anterior involvement of the optic nerve and bilateral presentation is more commonly seen with lower recurrence rates and poorer outcomes. The association with MS also appears to be lower.