Optic Neuritis in Malaysia: A 5 Years Review

Zunaina Embong

Purpose: To evaluate the clinical manifestations and visual outcomes of optic neuritis.

Methods: A retrospective review was performed involving 30 consecutive patients (39 eyes) with optic neuritis attending Hospital Universiti Sains Malaysia from July 2005 till June 2010.

Results: Majority of cases were Malay (86.7%) followed by Chinese (13.3%). Female was the predominant group (70%). The age of the patients involved were 5-55 year old with peak of ages between 21-30 year old (9 patients). Most patients had unilateral involvement (70%) and 30% had both eyes affected simultaneously. Majority of patients presented with acute blurring of vision of less than 1 week (71.8%) and no history of pain on ocular movement (56.4%). Twenty five eyes (64.3%) had visual acuity equal or worse than 1/60 on presentation. The commonest visual field defect was paracentral scotoma (28.2%).Optic disc papillitis was the commonest type (59%) followed by retrobulbar optic neuritis (30.7%) and neuroretinitis (10.3%). The main aetiology was found to be idiopathic (53.3%) with papillitis as the commonest optic disc changes (33.3%). Multiple sclerosis was diagnosed only in one patient. Those treated according to optic neuritis treatment trial had shown visual improvement of 6/12 and better (77.7%) at final follow up. The follow up ranges were from 4 months to 5 years.

Conclusion: Majority optic neuritis patients presented with acute visual loss with visual acuity equal and worse than 1/60 on presentation. Optic disc papillitis was the commonest type and the main aetiology was idiopathic. Majority of cases had good visual recovery.