The Clinical Profile of Idiopathic Optic Neuritis at the Ophthalmology OPD of Tertiary Centre of Army Hospital, Nepal

Abstract

Introduction: Inflammation of the optic nerve is a common cause of visual loss due to optic nerve pathology. This study was conducted to report the clinical features, demographic pattern and response to pulse steroid therapy in patients with idiopathic optic neuritis in a tertiary care teaching institute in Kathmandu, Nepal.
 Methods: The hospital data of patients with idiopathic optic neuritis admitted to the Department of Ophthalmology of Shree Birendra Hospital, Chhauni, Kathmandu, Nepal between Jan 2015 to Dec 2018 were retrospectively analysed. The parameters studied were demographic pattern, clinical features, and visual acuity. 
 Results: Eighteen eyes of 15 patients were found to have optic neuritis (papillits in eight and retrobulbar optic neuritis in 10 eyes). The male to female ratio was 1.4:1. The mean age of the patients was 38.07 ± 11.37 years (95% CI = 31.77- 42.37). The most common modes of presentation were loss of visual acuity, painful ocular movement and colour vision defect. One patient had features suggestive of multiple sclerosis. Response to pulse methylprednisolone therapy was good in most (16 eyes) of the cases except for the patients having recurrent episode and started oral steroid elsewhere before presenting to our hospital. 
 Conclusions: Response to pulse methylprednisolone therapy was good in patients with initial visual acuity of at least perception of light. Demographic and clinical features of our patients were different from those reported from the western world.

Clinical Etiology of Optic Neuropathy patients visiting BPKLCOS, Institute of Medicine, Nepal

“…1.5% of the patients had DOV, ocular pain, headaches, and diplopia. But, in contrast to our study conducted by Rajkarnikar et al [12] 46.6% of patients reported painful ocular movement, which is almost identical to the results of studies conducted in China by Zhang et al [11] (42.9%) and in the far-and mid-western regions of Nepal by Thapa et al (40%) [13] respectively. In another study, Godar et al [14] from Nepal and Saxena et al [15] from India both discovered higher (58%) and elevated (66%) occurrences of painful ocular movement.…”

“…The majority of patient eyes in our study (39.5%, n=34) exhibited greatest corrected visual acuity between 6/24-6/60.While (23.2%, n=20) of the population had visual acuity between 3/60 and 3/60, (19.8%, n=17) had visual acuity between 5/60 and 3/60, (14%, n=12) between 6/6 and 6/18, and (3.5%, n=3) had no perception of light. In a comparable study, Rajkarniker et al [12] found that although in the studies by Thapa et al [13] and Das et al [16] (23%) and Godar et al [14] (8%) individuals presented with no perception of light, 20% of patients did so in Rajkarniker's study [12].…”

“…It could not be done in 32.5% of the affected eyes (n=28), although it was normal in 11.7% of the affected eyes (n=10). 94% of the eyes in a study conducted by Rajkarniker et al, [12] had total colour blindness, and the remaining 6% had red-green deficiency. Total colour blindness was more prevalent, according to Shrestha et al [19], although Godar et al [14] study revealed that non-specific colour vision defects were more prevalent.…”

Optic Neuritis: Evaluation of Visual Acuity and Contrast Sensitivity. A Hospital Based Cross Sectional Study

“…A study published in India showed contradictory results with respect to our study as Pappilits was the most common type of ON. However studies done in past also showed that Retrobulbar Neuritis was the most common type of ON (Rajkarnikar, Gurung & Pant, 2021). Literature showed that Patients with an acute inflammatory phase, those recovering from optic neuritis, those with multiple sclerosis without a history of optic neuritis, and patients with acute inflammatory phases all have decreased contrast sensitivity in low, moderate, and high spatial frequencies .…”