Recovery From Severe Visual Loss in Optic Neuritis

TO THE EDITOR. —In our report of the results of the Optic Neuritis Treatment Trial1 and a subsequent article2 in the Archives, we recommended that intravenous methylprednisolone sodium succinate (250 mg every 6 hours for 3 days) followed by oral prednisone (1 mg/kg per day for 11 days) be considered for treatment of those patients with acute optic neuritis whose visual acuity decreased to less than 20/40. We concluded that there was no benefit to treatment with oral prednisone alone.Since most of the benefit of the intravenous regimen followed by the oral regimen is in the rate of recovery and not in the outcome at 6 months, the decision whether to recommend this regimen or no treatment to a patient with acute optic neuritis is not an easy one. Herein, we provide additional data to assist the clinician making this determination.As can be seen in the