A 29-year-old woman presents with acute painful unilateral visual loss and central scotoma. Fundus examination is normal. Visual evoked potentials show prolonged latency. She has no prior neurological episodes and her brain MRI is normal. She is treated with high-dose IV methylprednisolone. What is the expected benefit of this treatment?

• A It improves the final long-term visual outcome compared with placebo
• B It accelerates visual recovery but does not alter the final visual outcome ✓
• C It reduces her risk of developing multiple sclerosis to nearly zero
• D It converts the demyelinating lesion into complete remyelination

Explanation

The Optic Neuritis Treatment Trial established that high-dose IV methylprednisolone speeds visual recovery but does not improve final visual acuity compared with placebo, and oral prednisone alone is associated with higher recurrence rates and is avoided. In patients with abnormal brain MRI, steroids modestly delay conversion to clinically definite MS, but with a normal baseline MRI the long-term risk reduction is minimal, not near zero.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.