Optic Neuritis When Corticosteroid Therapy Did Not Restore Vision
This protocol addresses optic neuritis in patients who completed a high-dose corticosteroid course and did not achieve the expected degree of visual recovery.
Previous line — failure condition
Prior therapy: Intravenous methylprednisolone (followed by oral prednisolone)
The goal of this first-line approach is recovery of vision, with a visual acuity of 20/40 or better expected by 6 months. When that target is not reached, escalation to the next step is indicated.
Next-line approach — partial overview
After corticosteroid failure, management involves neurologist referral and discussion of immunomodulating therapy. Certain agents in this class have been shown to reduce the development and severity of further demyelinating disease — the specific selection and structured regimen are detailed in the full protocol.
References
DOI: 10.4103/0301-4738.77020
At present the immunomodulating drugs that have been shown to reduce the development and severity of CDMS include interferon β-1a (Avonex®, Rebif®), interferon β-1b (Betaseron®) and Glatiramer acetate.
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