Corticosteroids do not prevent optic nerve atrophy following optic neuritis

orticosteroids 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. 1 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. 2 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, 4 over a five year period in relapsing remitting MS. 5 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. 7 . . . . . . . . . .