Optic Neuritis: The Daily PANCE Blueprint
Which of the following is the most appropriate initial treatment for a patient diagnosed with optic neuritis?
A. Oral prednisone alone
B. IV methylprednisolone
C. Antibiotic eye drops
D. Emergent surgical intervention
E. Aspirin
Answer and topic summary
The answer is B. IV methylprednisolone
Optic neuritis is inflammation of the optic nerve (aka CN II). Key clinical features include: sudden visual loss (usually unilateral), color vision defects, impaired depth perception, periorbital pain with eye movement, and relative afferent pupillary defect. It is normally associated with multiple sclerosis and is often the first presenting sign of multiple sclerosis. Patients who are impacted are typically females between the ages of 20 and 40. Diagnosis is clinical, but an MRI study of the brain and orbits with/ gadolinium contrast is important to help assess the patient’s risk for MS. First-line treatment is IV methylprednisolone +/- disease-modifying therapy.
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