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Clinical Alert

January 21, 1992

Clinical Alert to Ophthalmologists and Neurologists who Treat Patients with Optic Neuritis

Dear Colleague:

This letter is to inform you of findings from the Optic Neuritis TreatmentTrial that warrant your attention prior to publication of the results. Thisrandomized, multicenter clinical trial was supported by the National Eye Institute,a component of the National Institutes of Health (NIH).

The trial evaluated the safety and efficacy of corticosteroid treatment inover 450 patients with optic neuritis. It found that oral prednisone (prescribedin a dosage of 1 mg/kg/day for 14 days) was not only ineffective in speedingrecovery or in improving the visual outcome after optic neuritis, but actuallyincreased a patient’s risk for future attacks in either the affected or felloweye.

Specifically, trial investigators found that 27 percent of the patients takingoral prednisone had at least one new attack of optic neuritis during follow-up,which for some patients was as long as two years. In contrast, patients whoreceived an oral placebo had a 15 percent rate of subsequent optic neuritis.

Based on these findings, the trial investigators have concluded that thereis no role for oral prednisone alone in standard dosages in the treatmentof patients with initial episodes of optic neuritis.

The complete findings from this study will be published soon. This announcementis being sent in advance of journal publication to ophthalmologists and neurologistslikely to treat patients with optic neuritis. A list of participating centersis included on the back of this sheet for your reference.


Carl Kupfer, M.D.
National Eye Institute

Roy W. Beck, M.D.
Study Chairman
Optic Neuritis Treatment Trial
Professor of Ophthalmology
University of South Florida