DOI: 10.36347/sjams.2020.v08i11.042

Pages: 2635-2643

Background: Optic neuritis (ON) is characterized by unilateral or bilateral sudden loss of vision, often accompanied by periocular pain due to idiopathic, inflammatory, infectious or demyelinating causes. When compared to the Western population, various studies from Asia suggest that there is difference in aetiology, clinical presentation and prognosis of optic neuritis. Few Indian studies are available evaluating the natural course following first attack of optic neuritis. Methods: This prospective observational study was conducted on 20 patients. Inclusion criteria included age range of 18 to 50 years, acute unilateral or bilateral optic neuritis with visual symptoms for less than or equal to 1 week associated with at least 2 of the following: colour vision abnormality, pain on eye movement, afferent papillary defect, and abnormal visual-evoked potential (VEP). Patients having toxic, metabolic, vascular, and infective causes for optic neuritis were excluded from the study. CSF study including oligo-clonal band (OCB), S. NMO antibody, MRI Brain and spine were done for all patients. Patients were followed up at 3 months, 6 months and 1 year with detailed clinical examination and VEP to assess visual recovery and development of new neurological deficits. Results: Female (n= 12) preponderance was seen in a ratio of 3: 2. Recurrent optic neuritis was seen in one patient with idiopathic optic neuritis. During one year follow up, 3 patients developed additional neurological deficits of which 2 were having MS and 1 having NMO. Patients with MS were having short segment demyelinating lesion and the one with NMO was having LETM and cord oedema. Bilateral ON was seen in 2 patients (one S. NMO and the other S. anti MOG antibody positive). There was statistically significant association with (p value =0.01) increase in the number of lesions in the follow up MRI brain and development of multiple sclerosis. Visual outcome was better in patients with idiopathic ON and optic......