Clinical profiles of patients with optic neuritis and papillitis: A prospective study

To analyse the demographics and presenting features of patients presenting with optic neuritis and papillitis. Clinical profiles of 40 patients presenting with optic neuritis and papillitis at a tertiary care center were collected retrospectively and prospectively. Detailed medical and ophthalmic history was taken especially about mode, duration and course of the disease, drug intake, alcoholism, smoking, pregnancy, lactation, convulsions, pyrexia, history suggestive of TB, syphilis, neurological deficit. A comprehensive ophthalmological and neurological evaluation was done for each patient along with radiological work up. Patients were prospectively followed up for an average of three months. Females in the reproductive age group constituted largest number of the patients (61.8%) in the present series. Maximum patients (70%) were between 20-50 years of age. Vision was found to be affected in all the patients at presentation and most of them presented with vision CF or HM (35.4% and 29.25% respectively) while 4 patients had complete loss of vision. Two third (66.7%) of patients reported eye pain at presentation. Abnormal pupillary reaction was found in most patients with the most common being RAPD on swinging flash light which was seen in 85.4%. Equal percentage (39.5%) of patients presented with Blurred Hyperemic (BH) disc and ophthalmoscopically normal appearing disc. Onset and progression of disease was found to be rapid in most cases ranging from few hours to days. Visual recovery post treatment was found to be good with most eyes achieving vision 6/24 or better. Optic neuritis has varied clinical presentations. Most of our patients were young to middle aged females. The most common presenting features were decrease in vision ranging from slight to profound, eye pain and abnormal pupillary reaction. Morphological abnormalities in appearance of optic disc were also found in two third of cases.Rapid progression was noted in almost all cases. Most of the cases achieved a good outcome at the end of follow up period.