Erythropoietin for Optic Neuritis

Inflammatory optic neuropathy remains the most common acute optic neuropathy in patients under the age of 50 years. The most common cause for inflammatory optic neuropathy is sterile inflammation from demyelination, with multiple sclerosis (MS) as the most common associated condition. This is the type of optic neuropathy most commonly referred to as “optic neuritis.” The inflammation more commonly occurs posteriorly, does not cause optic disc edema, and is termed retrobulbar optic neuritis. For the last 25 years or so, and primarily based on information from the optic neuritis treatment trial (ONTT),[1] the standard treatment for acute inflammatory optic neuritis has been high dose corticosteroids, typically given intravenously for 3– 5 days, followed by oral steroids. The expectation is that corticosteroids will hasten visual improvement without altering the degree of recovery of visual function. There has been a relative paucity of adjunctive agents that have been used in conjunction with corticosteroids. Given the persistent deficits that remain after a bout of optic neuritis, there remains an unmet need for neuroprotective therapy.