Corticosteroids do not prevent optic nerve atrophy following optic neuritis.

Corticosteroids shorten the period of functional impairment following relapses in optic neuritis and multiple sclerosis (MS); however they have not, thus far, been shown to affect the final level of function compared with placebo. There has been recent interest in the use of corticosteroids as neuroprotective agents by their effect of decreasing nitric oxide (NO) production by mononuclear cells. NO is toxic to axons in vitro. Pulsed corticosteroid treatment has been reported to reduce the development of cerebral atrophy, a putative marker of neuronal loss, over a five year period in relapsing remitting MS. Optic nerve atrophy has been shown to develop following optic neuritis. This study assesses whether a single course of intravenous methylprednisolone (IVMP) during an attack of acute optic neuritis prevents the development of optic nerve atrophy following optic neuritis. Magnetic resonance imaging (MRI) data from a recent randomised placebo controlled trial of IVMP in acute optic neuritis were retrospectively evaluated.