The ONTT (Optic Neuritis Treatment Trial) demonstrated that high-dose IV methylprednisolone for optic neuritis:

• A Improved final visual acuity at 1 year compared to oral prednisone
• B Reduced the 2-year risk of developing MS
• C Accelerated visual recovery but did not improve final visual outcome, and reduced short-term MS risk ✓
• D Was inferior to oral prednisone for reducing MS conversion risk

Explanation

The ONTT showed that IV methylprednisolone (1g/day x 3 days followed by oral prednisone) accelerated visual recovery compared to placebo and reduced the 2-year risk of MS conversion only in patients with two or more MRI lesions. Importantly, final visual acuity at 1 year was similar across all treatment groups. Unexpectedly, oral prednisone alone (1 mg/kg/day) was associated with a higher relapse rate in the treated eye, making it contraindicated as monotherapy for optic neuritis. This trial established IV corticosteroids as the treatment of choice when treatment is decided upon.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.