Management of optic neuritis and impact of clinical trials: An international survey

Biousse, Valérie; Calvetti, Olivier; Drews‐Botsch, Carolyn; Atkins, Edward J.; Sathornsumetee, Busaba; Newman, Nancy J.

doi:10.1016/j.jns.2008.08.039

Cited by 37 publications

(23 citation statements)

References 38 publications

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“…The ophthalmologist usually followed the recommendations from the ONTT study to treat children with optic neuritis; however, the pediatric neurologist might not manage children in ways consistent with the ophthalmologist in clinical practice, which was also reported in a previous study. 34 The main reason might be because of no standard guidelines from evidence-based research like the ONTT study in treating pediatric patients with optic neuritis. Nevertheless, intravenous methylprednisolone (10-30 mg/kg/day Â 3-5 days) then taper from oral prednisolone for at least 4 weeks is still recommended to hasten visual recovery in children with optic neuritis.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of optic neuritis in Taiwanese children

Sun

et al. 2011

Eye

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics of optic neuritis in Taiwanese children

Sun

et al. 2011

Eye

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“…It is commonly assumed that clinical evidence ultimately transforms clinical management by health professionals and results in better patient outcomes. Recently it has been highlighted that evaluation of the impact of major clinical trials "Translational T2 Clinical Research" is essential when assessing the effects of interventions designed to improve quality of care [1,2]. Although such translational research is important to implement change, there are other barriers to change that may occur at the level of the patient, the clinician or the healthcare system [1,3].…”

Section: Introductionmentioning

confidence: 99%

Patients' knowledge and perception on optic neuritis management before and after an information session

Matti

Keane

McCarl³

et al. 2010

BMC Ophthalmol

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BackgroundPatients' understanding of their condition affect the choice of treatment. The aim of this study is to evaluate patients' understanding and treatment preferences before and after an information session on the treatment of acute optic neuritis.MethodsParticipants were asked to complete a questionnaire consisting of 14 questions before and after an information session presented by a neuro-ophthalmologist. The information session highlighted the treatment options and the treatment effects based on the Optic Neuritis Treatment Trial in plain patient language. The information session stressed the finding that high dose intravenous steroid therapy accelerated visual recovery but does not change final vision and that treatment with oral prednisone alone resulted in a higher incidence of recurrent optic neuritis.ResultsBefore the information session, 23 (85%) participants knew that there was treatment available for ON and this increased to 27 (100%) after the information session. There were no significantly change in patients knowledge of symptoms of ON and purpose of treatment before and after the information session. Before the information session, 4 (14%) respondents reported they would like to be treated by oral steroid alone in the event of an optic neuritis and 5 (19%) did not respond. After the education session, only 1 patient (4%) indicated they would undergo treatment with oral steroid alone but 25 (92%) indicated they would undergo treatment with intravenous steroid treatment, alone or in combination with oral treatment. Results indicated that there were significant differences in the numbers of participants selecting that they would undergo treatment with a steroid injection (n = 22, p = 0.016).ConclusionsIn this study, patients have shown good understanding of the symptoms and signs of optic neuritis. The finding that significant increases in the likelihood of patients engaging in best practice can be achieved with an information session is very important. This suggests that patient knowledge of available treatments and outcomes can play an important role in implementing and adopting guideline recommendations.

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“…In the face of substantial data arguing against the use of systemic CS, physicians continue to treat ON with CS in the US [30,31]. When surveyed, many ophthalmologists and neurologists believe that CS enhances visual recovery.…”

Section: Corticosteroids Use In Optic Neuritismentioning

confidence: 99%

Glucocorticosteroids: Risk-Benefit Appraisals in Multiple Sclerosis and MS-Associated Optic Neuritis

2017

j of exper clin neur

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Glucocorticosteroids/GC are the cornerstone of immunosuppression utilized for decades in the treatment of multiple sclerosis (MS) and MS-related optic neuritis (MS-ON). Steroids are often prescribed as either 'monotherapy' or add-on in structured 'polytherapy' regimens or concomitant with other immunosuppressants and/or immunomodulatory drugs, depending upon the disease situation. This review focuses on the pharmacologic corticosteroids, such as methylprednisolone, that are prevalently utilized in MS care. Among other aims, the treatment effects on dynamic patterns of cerebral atrophy, optic nerve inflammation and neurodegeneration are evaluated, and a risk stratification of patients with MS and MS-ON is presented. It provides details on selected case reports, as well as pivotal clinical studies and attributable significant (clinically important) outcomes. It then addresses primarily the outcomes related to demyelination or neurodegeneration, myelin repair or neuroregeneration, and the undesirable such safety issues as ataxia, avascular necrosis, infections, and cerebral atrophy. At the end, we put together a critical assessment of both explicit and implicit observations on various treatment configurations, including NOAEL (no observed adverse effect level) dosing for reasons where it is currently unclear whether or ever a safe and effective clinical dosing of steroids is established in clinical trials for MS and MS-ON, discuss impartially the current state-ofknowledge, identify scientific data gaps, and offer a fresh perspective on how to improve the benefits and minimize the risks of steroids in multiple sclerosis.

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Management of optic neuritis and impact of clinical trials: An international survey

Cited by 37 publications

References 38 publications

Clinical characteristics of optic neuritis in Taiwanese children

Clinical characteristics of optic neuritis in Taiwanese children

Patients' knowledge and perception on optic neuritis management before and after an information session

Glucocorticosteroids: Risk-Benefit Appraisals in Multiple Sclerosis and MS-Associated Optic Neuritis

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