According to the Optic Neuritis Treatment Trial, what is the established effect of intravenous methylprednisolone given for acute demyelinating optic neuritis?

• A It improves final visual acuity at 1 year compared with placebo
• B It accelerates visual recovery but does not improve final visual outcome ✓
• C It reduces conversion to multiple sclerosis by more than half
• D It is inferior to oral prednisolone 60 mg daily

Explanation

The Optic Neuritis Treatment Trial showed that intravenous methylprednisolone speeds the rate of visual recovery in the short term but does not alter final visual acuity compared with placebo. It also modestly delayed, but did not prevent, later conversion to multiple sclerosis. Notably, low-dose oral prednisolone alone was associated with a higher recurrence rate of optic neuritis, so it should not be used alone for acute optic neuritis.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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