Official websites use. Share sensitive information only on official, secure websites. Reviewed by: Jane W. This article was submitted to Frontiers in Neuro-ophthalmology, a specialty of Frontiers in Neurology. This is an open-access article distributed under the terms of the Creative Commons Attribution Non Commercial License , which permits non-commercial use, distribution, and reproduction in other forums, provided the original authors and source are credited.
The optic neuritis treatment trial ONTT and subsequent studies have had a tremendous impact on the treatment and prognosis of optic neuritis and multiple sclerosis in adults. The results of these studies have been extrapolated to children; however, pediatric data are sparse. Using the method of prospective preference assessment, the willingness of parents and medical professionals to enroll children in a hypothetical Pediatric ONTT was assessed using a mock consent form and questionnaire.
A three-arm trial was proposed: 1 intravenous corticosteroids, 2 high-dose oral corticosteroids, and 3 an oral placebo. The forms were completed by parents and 49 physicians. Keywords: optic neuritis, children, clinical trial, prospective preference assessment. Optic neuritis is an acute, inflammatory disease of the optic nerve and is often the initial manifestation of multiple sclerosis MS in adults and children Duquette et al.
The clinical profile may include sudden vision loss, dyschromatopsia, pain with eye movements, and visual field defects Optic Neuritis Study Group, ; Beck et al. Recovery often occurs over the course of several months; however, patients may have long-lasting symptoms of visual impairment Sanders et al. Even if visual acuity returns to baseline, abnormalities in color vision, visual field, and contrast sensitivity may persist Optic Neuritis Study Group, b. In adults, the optic neuritis treatment trial ONTT has shown that the administration of intravenous corticosteroids hastens visual recovery, but does not affect the long-term visual or neurologic prognosis when compared to placebo Optic Neuritis Study Group, b.
Despite insufficient evidence in the pediatric age group of long-term efficacy and the potential for adverse reactions even with short-term therapy, most pediatric ophthalmologists and neurologists still prescribe a short course of intravenous corticosteroids as treatment for acute optic neuritis in children, largely based on the results of the adult trial Cakmakli et al.
