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Audience

  • NHS Highland
  • Secondary Care 
  • Adults Only 

 

This guidance outlines the acute diagnostic evaluation and initial management of patients presenting with suspected optic neuritis in the eye casualty department.

Optic neuritis pathway

References

  • Simon J. Hickman & Axel Petzold (2022) Update on Optic Neuritis: An International View, Neuro-Ophthalmology, 46:1, 1-18, DOI: 10.1080/01658107.2021.1964541
  • Morrow SA, Fraser JA, Day C, Bowman D, Rosehart H, Kremenchutzky M, Nicolle M. Effect of Treating Acute Optic Neuritis With Bioequivalent Oral vs Intravenous Corticosteroids: A Randomized Clinical Trial. JAMA Neurol. 2018 Jun 1;75(6):690-696.
  • Naumovska M, Sheikh R, Bengtsson B, Malmsjö M, Hammar B. Visual outcome is similar in optic neuritis patients treated with oral and i.v. high-dose methylprednisolone: a retrospective study on 56 patients. BMC Neurol. 2018 Sep 29;18(1):160
  • Compston A, Coles A. Multiple sclerosis. Lancet. 2002;359 (9313):1221–1231. doi:10.1016/S0140-6736(02)08220-X.
  • Petzold A, Braithwaite T, van Oosten BW, et al. Case for a new corticosteroid treatment trial in optic neuritis: review of updated evidence. J Neurol Neurosurg Psychiatry. 2020;91(1):9–14. doi:10.1136/jnnp-2019- 321653.
  • Hickman SJ, Dalton CM, Miller DH, Plant GT. Management of acute optic neuritis. Lancet. 2002;360(9349):1953-1962.
  • Horton L, Bennett JL. Acute Management of Optic Neuritis: An Evolving Paradigm. J Neuroophthalmol. 2018 Sep;38(3):358-367
  • Beck RW, Cleary PA, Anderson MM et al A randomized controlled trial of corticosteroids in the treatment of acute optic neuritis N Engl J Med 1992;326:581-588

Editorial Information

Last reviewed: 24/04/2025

Next review date: 30/04/2028

Author(s): Ophthalmology.

Version: 1

Approved By: TAM Subgroup of the ADTC

Reviewer name(s): T Leslie, Consultant Ophthalmologist, R Brennan, Consultant Ophthalmologist.

Document Id: TAM680

References

Further information for patients