Purpose: To analyse the presentation, aetiology, management and outcome of
patients with optic neuritis (ON) in Singapore.
Methods: This was a retrospective study involving consecutive patients with
ON presenting at the Singapore National Eye Centre between January 1997 an
d May 1999. The presenting features, investigations, treatment and visual o
utcome after 6 months were studied.
Results: A total of 31 patients (39 eyes) presented with ON during this per
iod, 17 of whom had anterior ON. No aetiology was found in 26 patients (83.
9%), two patients (6.5%) had multiple sclerosis, one had active syphilis, o
ne had rheumatoid arthritis and another had pan-sinusitis. Seventeen patien
ts (54.8%) were treated with intravenous methyl-prednisolone followed by or
al prednisolone. Within the follow-up period 26 of 31 eyes (83.9%) with idi
opathic ON attained visual acuity of 6/12 or better, with 12 (38.7%) recove
ring to 6/6 or better and only one eye ending with less than 6/60 visual ac
uity. The one patient with syphilis recovered 6/6 visual acuity bilaterally
. Both patients with multiple sclerosis also had good visual recovery at 6
months. The visual outcome in those cases of ON associated with rheumatoid
arthritis and pan-sinusitis was poor with visual acuity of less than 6/60 a
t 6 months follow up in each instance.
Conclusion: The majority of the cases of ON in this study were idiopathic.
There was a low association with multiple sclerosis. Most patients had good
visual recovery within 6 months.