Treatment of Optic Neuritis with Intravenous Megadose Corticosteroids

Twelve consecutive patients with optic neuritis of unknown etiology treated with 250 to 500 mg methylprednisolone every 6 hours are described. All patients improved, some dramatically and rapidly. Patients with swollen discs and visual loss for less than 6 weeks improved uniformly, rapidly, and completely. In some patients, progressive visual deterioration was reversed rapidly. Serum serologies and cerebrospinal fluids findings were of limited use in determining etiology or prognosis with treatment. Side effects included exacerbation of a preexisting psychosis, elevated glucose levels, and oral candidiasis. None required cessation of treatment. Patients with optic neuritis may benefit from intravenous megadose corticosteroids.