Bilateral Optic Neuritis Treated with Intravenous Corticosteroid

Introduction: Optic neuritis is a term used to refer an inflammation of the optic nerve. Bilateral optic neuritis in adults has been considered rare particularly in individuals without known systemic inflammatory or autoimmune disorders. Purpose: To describe cases of acute bilateral optic neuritis in adult treated with intravenous corticosteroid in M. Djamil Hospital, Padang, Indonesia. Method: We performed a retrospective study review of medical records from patients referred to neuro‐ ophthalmology clinic in M. Djamil Hospital with acute bilateral optic neuritis from January 2016 to April 2017. Exclusion criteria included previous multiple sclerosis or myelopathy, known systemic disorders or medications associated with optic neuropathy, uveitis, or neoplasm. Patients received intravenous methylprednisolone followed by tappering oral metilprednisolone. Visual acuity, visual fields, ophthalmoscopy finding, and neurological evaluation were recorded at baseline and at 1 month or 3 months. Result: Nine patients of 4 men and 5 women, with an age range of 21-45 years old, had bilateral decreased vision, 6 with pain on eye movement. All patients had normal neurological evaluations, with visual acuity ranging from finger counting to hand movement and variety of visual field pattern. Both optic nerves showed abnormal ophthalmoscopy finding. After corticosteroid therapy for average 2 weeks, all patients show improvement in visual acuity, visual field, and ophthalmoscopy finding. No patient developed a neurological problem during the follow up with a mean of 3 months. Conclusion: Idiopathic acute bilateral optic neuritis rarely occurs in adults. Corticosteroid therapy shows good visual outcome.