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Many patients with optic neuritis are left with permanent visual deficits. Past studies of therapy with corticotropin or triamcinolone have failed to demonstrate a benefit, and corticosteroids, though widely used, have not been rigorously evaluated.
This multicenter trial randomized 457 patients with acute, symptomatic optic neuritis to receive either 3 days of intravenous methylprednisolone followed by 11 days of oral prednisone, oral prednisone for 14 days, or placebo for 14 days. Visual function recovered faster with IV methylprednisolone than with placebo, and at six months the IV therapy group continued to have better visual field, contrast sensitivity, and color vision than the other groups, but not better visual acuity. Recovery rates…