The Optic Neuritis Treatment Trial: Three-Year Follow-up Results

Abstract

The Optic Neuritis Treatment Trial (ONTT) is a multicenter study funded by the National Eye Institute, Bethesda, Md, that was developed to evaluate the benefit of corticosteroids as treatment for acute optic neuritis as well as to investigate the relationship between optic neuritis and multiple sclerosis (MS). We previously reported that, compared with oral placebo treatment (oral placebo group), (1) treatment with high-dose intravenous followed by oral corticosteroids (intravenous group) accelerated visual recovery but provided no long-term benefit to vision^1,2; (2) treatment with "standard-dose" oral prednisone alone (oral prednisone group) did not improve the visual outcome and was associated with an increased rate of new attacks of optic neuritis^1,2; and (3) treatment with the intravenous followed by oral corticosteroid regimen reduced the 2-year rate of development of MS, particularly in patients with signal abnormalities consistent with demyelination on magnetic resonance imaging (MRI) of the brain at the time