Dr. JAI GOPAL AGRAWAL

DR. ADITYA ANAND

Abstract

Objective: Earliest treatment (minimum time) from onset of symptom to high-dose IV MP predicts visual recovery in cases of optic neuritis known for poor recovery.

Methods: A retrospective study was performed in patients following their first aquaporin-4 (AQP4) or myelin oligodendrocyte glycoprotein (MOG)-ON. BCVA at 1 month and 3 months (BCVA1mo & BCVA3mo) was correlated with time to IVMP (days). A total of 38 patients had ON (30 AQP4-ON and 8 MOG-ON). All pts were followed for next three years for visual stability, recovery, recurrences and visual recovery after recurrent episode with same treatment protocol.

Results: ROC analysis revealed that the optimal criterion of delay in IVMP initiation was ≤4 days, with a sensitivity and specificity of 73.6% & 77.1% & best recovery.

Conclusions: Time is vision for treatment of ON. As hyperacute treatment with IVMP increases chance for good visual recovery (20/20 vision) and even a 7-day delay in IVMP t/t was detrimental to visual outcome.

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