A 28-year-old woman presents with painful unilateral visual loss and reduced color vision over 3 days. Fundoscopy is normal. Visual acuity is 6/36. What did the Optic Neuritis Treatment Trial establish about treatment?

• A Oral prednisolone alone improves final visual outcome
• B No treatment alters recovery rate or outcome compared with placebo
• C Plasma exchange improves final visual acuity
• D IV methylprednisolone speeds recovery but does not improve final visual outcome ✓

Explanation

The Optic Neuritis Treatment Trial showed high-dose IV methylprednisolone accelerates visual recovery but does not change final visual acuity at 6 months. It also found oral prednisolone in conventional dose was associated with a higher recurrence rate, so it is avoided as monotherapy. Plasma exchange has no established role in typical demyelinating optic neuritis.

Reference: Bradley's Neurology in Clinical Practice, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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